Dihydroindolizinone derivative

ABSTRACT

A compound represented by general formula (I) (wherein all symbols are as defined in the description) or a salt, solvate, N-oxide form or prodrug thereof is a potent FXIa inhibitor, has excellent oral absorption properties and kinetics in blood, can exert a potent anti-coagulation activity over a long period of time after being administered orally, and has a discrepancy between the anti-coagulation activity thereof and the CP-inhibiting activity thereof. Therefore, the compound or the salt, solvate, N-oxide form or prodrug thereof can be used as an efficient prophylactic and/or therapeutic agent for vascular occlusive diseases.

TECHNICAL FIELD

The present invention relates to a compound represented by generalformula (I):

(wherein, all the symbols have the same meanings as described below), asalt thereof, a solvate thereof, an N-oxide thereof or a prodrug thereof(hereinafter occasionally abbreviated as the compound of the presentinvention).

BACKGROUND ART

Thrombosis and thromboembolism which is a complication of thrombosis(hereinafter referred to as thromboembolic disease) are ranked highalong with cancer as the cause of death of adults, and have becomeimportant problems in recent years. Thromboembolic disease occurs by theformation of a thrombus at a site of vascular injury. Alternatively,thromboembolic disease occurs when a thrombus is released and is carriedby the blood stream into another blood vessel where the thrombusobstructs a blood vessel at another site, Thromboembolic diseaseincludes, for example, venous thromboembolism which is a collective termfor deep venous thrombosis and pulmonary embolism, cerebral stroke,angina pectoris, myocardial infarction, other various arterial andvenous thrombosis and the like.

Tissue factor expressed on a vascular wall due to the injury of a bloodvessel and the like becomes the starting point of the blood coagulationcascade and forms a complex with blood coagulation factor VII which ispresent in blood in a very small quantity. This complex activates bloodcoagulation factor IX and blood coagulation factor X, and activatedblood coagulation factor X converts prothrombin to thrombin. Thrombinconverts fibrinogen to fibrin and finally insoluble fibrin is formed(the initial stage), It is supposed that thrombin produced in theprocess promotes the formation of a thrombus at the initial stage and isimportant for hemostasis. On the other hand, it has been reported thatthrombin activates blood coagulation factor XI and causes explosivethrombin production via activated blood coagulation factor XI(hereinafter also referred to as FXIa) (the amplification stage), whichresults in an increase in thrombi (see Non Patent Literatures 1 to 3).

For the treatment and/or prevention of thromboembolic disease,anticoagulant agents are generally used. Though conventionalanticoagulant agents exhibit excellent antithrombotic actions, bleedingcomplications, which are serious side effects, have been problematic.Alternatively, in order not to cause bleeding complications, the dosesof the agents are limited and it is supposed that there is a possibilitythat the agents do not exhibit sufficient antithrombotic actions. Undersuch conditions, an agent for treating and/or preventing thrombosis andthromboembolism having a novel mechanism of action, which suppresses thegrowth of or increase in pathological thrombi and does not affect theformation of hemostatic thrombi, is required. As one of the targets ofthe agent, FXIa is attracting attention in recent years. Bloodcoagulation factor XI is one of plasma serine proteases which areinvolved in the regulation of blood coagulation and becomes FXIa byactivated blood coagulation factor XII, thrombin or itself. FXIa is oneof constituents of the blood coagulation pathway which is referred to asthe intrinsic system or the contact system in the classical bloodcoagulation cascade and activates blood coagulation factor IX byselectively cleaving peptide bonds of Arg-Ala and Arg-Val. The safety ofFXIa is supported by the observations that the blood coagulation factorXI deficiency in humans, which is called hemophilia C, results in mildto moderate bleeding characterized primarily by postoperative orposttraumatic hemorrhage. In addition, the effects and the high safetyof FXIa are demonstrated by the experimental results of experimentalthrombosis and bleeding models which used blood coagulation factor XIdeficient mice and the experimental results of an anti-blood coagulationfactor XI neutralizing antibody or an antisense in experimentalthrombosis and bleeding models which used monkeys or rabbits, inaddition to the results of observations of the blood coagulation factor.XI deficiency in humans (see Non Patent Literatures 4 to 8).

Based on the above results, it is expected that FXIa is a veryattractive target without exhibiting the side effect of bleeding whendeveloping an antithrombotic agent for treatment and/or prevention andan FXIa inhibitor becomes a very potent and safe antithrombotic agentfor treatment or prevention without having any undesirable side effectssuch as bleeding.

Incidentally, as compounds of prior arts to the present invention, thefollowing compounds are described:

It has been described in Patent Literature 1 that a compound representedby general formula (A):

(wherein, A^(A) represents a 5- to 12-membered heterocycle or the like;L_(1A) represents —CH═CH— or the like; R^(11A) represents benzyl or thelike; and M^(A) represents imidazolyl or the like) is useful as aselective inhibitor of FXIa or a dual inhibitor of FXIa and plasmakallikrein.

In addition, it has been described in Patent Literature 2 that acompound represented by general formula (B-I):

(wherein, A^(B) represents a 5- to 12-membered heterocycle or the like;L_(1B) represents —CH═CH— or the like; R^(11B) represents benzyl or thelike; R^(3B) represents phenyl or the like; R^(4B) represents chlorineor the like; R^(8aB) represents hydrogen or the like); or generalformula (B-II):

(wherein, Ne represents pyridyl or the like; and the other symbols havethe same meanings as described above) inhibits FXIa and/or plasmakallikrein.

Further, it has been described in Patent Literature 3 that a compoundrepresented by general formula (C):

(wherein, W^(C) represents CO or the like; G^(C) represents a directbond or the like; G^(1C), G^(2C), G^(3C) and G^(4C) each independentlyrepresent C or N or the like; R^(9C) represents an aryl or the like; ROCrepresents a heteroaryl or the like; and R^(1AC) represents aheteroarylalkyl or the like) is useful as a γ secretase modulator.However, it is not reported that the compound represented by formula (C)has an FXIa inhibitory activity.

Furthermore, it has been described in Patent Literature 4 that acompound represented by general formula (D)

(wherein, R_(1D) represents hydrogen or the like; R_(2D) represents anaryl or the like; R_(3D) represents hydrogen or the like; R_(4D)represents hydrogen or the like; and R_(5D) represents a heteroarylalkylor the like) is useful as a p38 MAP kinase modulator.

In addition, it has been described in Patent Literature 5 that acompound represented by general formula (E)

(wherein, L^(E) represents a linker providing 0 to 6 atoms or the like;X^(E) represents a heteroaryl or the like; Z^(E) represents a halogen orthe like; Q^(E) represents CO or the like; and R^(2E) and R^(3E) eachindependently represent hydrogen, an aryl or the like) is useful as adipeptidyl peptidase inhibitor.

Further, it has been described in Patent Literature 6 that a compoundrepresented by general formula (F)

(wherein, Cyc^(1F) represents a 5- to 10-membered heteroaryl or thelike, represents a C5-C10 aryl or the like, Cyc^(3F) represents a C5-C10aryl or a 5- to 10-membered heteroaryl or the like, U represents CH₂ orthe like, Y represents N or C(R^(5F)) or the like, and R^(6F) representsa 5-to 10-membered heteroaryl or the like) is useful as a selectiveinhibitor of FXIa or a dual inhibitor of FXIa and plasma kallikrein.

However, none of literature specifically discloses the compound of thepresent invention, CITATIONS LISTS

PATENT LITERATURES

-   Patent Literature 1: WO 2007070826 A-   Patent Literature 2: WO 2008076805 A-   Patent Literature 3: WO 2009076337 A-   Patent Literature 4: WO 2003068230 A-   Patent Literature 5: EP 1 506 967 A1-   Patent Literature 6: WO 2013093484 A

Non Patent Literatures

-   Non Patent Literature 1: Blood Coagulation and Fibrinolysis, 2006,    Vol, 17, pages 251-257-   Non Patent Literature 2: Science, 1991, Vol, 253, pages 909-912-   Non Patent Literature 3: Blood, 2003, Vol. 102, pages 953-955-   Non Patent Literature 4: Journal of Thrombosis and Haemostasis,    2005, Vol, 3, pages 695-702 Non Patent Literature 5: Journal of    Thrombosis and Haemostasis, 2006, Vol, 4, pages 1982-1988-   Non Patent Literature 6: Blood, 2012, Vol, 119, pages 2401-2408-   Non Patent Literature 7: Blood, 2009, Vol. 113, pages 936-944-   Non Patent Literature 8: Journal of Thrombosis and Haemostasis,    2006, Vol., 4, pages 1496-1501

SUMMARY OF INVENTION Technical Problems

An object of the present invention is to develop a compound which is apotent FXIa inhibitor, is excellent in oral absorbability and kineticsin blood, exhibits a potent anticoagulation activity for a long periodof time after oral administration and has a discrepancy between theanticoagulation activity and a CYP inhibitory activity.

Solutions to Problems

The present inventors have carried out intensive studies in order toachieve the above-described object. As a result, the present inventorshave found that the compound of the present invention is capable ofachieving the above-described object, and have completed the presentinvention.

In other words, the present invention relates to the followings:

[1] A compound represented by general formula (I):

represents:

represents:

and X represents CH or N];a salt thereof, a solvate thereof, an N-oxide thereof ora prodrug thereof;

[2] the compound according to the above item [1], wherein the compoundrepresented by general formula (I) is(3S)-3-[5-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H-imidazol-2-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone,a salt thereof, a solvate thereof, an N-oxide thereof or a prodrugthereof;

[3] the compound according to the above item [1], wherein the compoundrepresented by general formula (I) is(3S)-3-[2-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H-imidazol-5-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone,a salt thereof, a solvate thereof, an N-oxide thereof or a prodrugthereof;

[4] the compound according to the above item [1], wherein the compoundrepresented by general formula (I) is(6S)-6-[2-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H-imidazol-5-yl]-2-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-7,8-dihydropyrrolo[1,2-a]pyrimidin-4(6H)-one,a salt thereof, a solvate thereof, an N-oxide thereof or a prodrugthereof;

[5] the compound according to the above item [1], wherein the compoundrepresented by general formula (I) is1-(2-{(3S)-3-[5-(4-aminophenyl)-4-fluoro-1H-imidazol-2-yl]-5-oxo-1,2,3,5-tetrahydro-7-indolizinyl}-4-chlorophenyl)-1H-1,2,3-triazole-4-carbonitrile,a salt thereof, a solvate thereof, an N-oxide thereof or a prodrugthereof;

[6] a pharmaceutical composition comprising the compound according toany one of the above items [1] to [5], a salt thereof, a solvatethereof, an N-oxide thereof or a prodrug thereof as an activeingredient;

[7] an FXIa inhibitor comprising the compound according to any one ofthe above items [1] to [5], a salt thereof, a solvate thereof, anN-oxide thereof or a prodrug thereof as an active ingredient;

[8] an agent for preventing and/or treating thromboembolic disease,comprising the compound according to any one of the above items [1] to[5], a salt thereof, a solvate thereof, an N-oxide thereof or a prodrugthereof as an active ingredient;

[9] the agent according to the above item [8], wherein thethromboembolic disease is arterial cardiovascular thromboembolicdisorder, venous cardiovascular thromboembolic disorder, arterialcerebrovascular thromboembolic disorder, venous cerebrovascularthromboembolic disorder or thromboembolic disorder in the heart chamberor in the peripheral circulation;

[10] the agent according to the above item [8] or [9], wherein thethromboembolic disease is coronary artery disease, unstable angina,acute coronary syndrome, atrial fibrillation, myocardial infarction,ischemic sudden death, transient ischemic attack, cerebral stroke,peripheral arterial disease, atherosclerosis, peripheral occlusivearterial disease, venous thrombosis, venous thromboembolism, deep venousthrombosis, thrombophlebitis, arterial embolism, coronary arterythrombosis, cerebral arterial thrombosis, cerebral embolism, kidneyembolism, portal vein thrombosis, pulmonary embolism, pulmonaryinfarction, liver embolism, hepatic veno-occlusive disease/sinusoidalobstruction syndrome, thrombotic microangiopathy, disseminatedintravascular coagulation, sepsis, acute respiratory distress syndrome,acute lung injury, antiphospholipid antibody syndrome, thrombosisresulting from coronary artery bypass graft surgery or thrombosisinduced by treatment in which blood is exposed to an artificial surfacewhich promotes thrombus formation;

[11] the agent according to any one of the above items [8] to [10],wherein the thromboembolic disease is venous thromboembolism, ischemicstroke, thromboembolic disease induced by treatment in which blood isexposed to an artificial surface which promotes thrombus formation,acute coronary syndrome, coronary artery disease or peripheral arterialdisease;

[12] the compound according to any one of the above items [1] to [5], asalt thereof, a solvate thereof, an N-oxide thereof or a prodrug thereoffor preventing and/or treating thromboembolic disease;

[13] use of the compound according to any one of the above items [1] to[5], a salt thereof, a solvate thereof, an N-oxide thereof or a prodrugthereof for manufacture of an agent for preventing and/or treatingthromboembolic disease; and

[14] a method for preventing and/or treating thromboembolic disease,comprising administering an effective dose of the compound according toany one of the above items [1] to [5], a salt thereof, a solvatethereof, an N-oxide thereof or a prodrug thereof to a patient in need ofprevention and/or treatment of the thromboembolic disease;

and the like.

Advantageous Effects of Invention

The compound of the present invention is a potent FXIa inhibitor, andtherefore, is an effective agent for preventing and/or treatingthromboembolic disease.

BRIEF DESCRIPTION OF DRAWINGS

FIG. 1 shows the change in the concentration of the compound in theplasma of the compound described in Example 2 (10) when being orallyadministered to rats (1 mg/kg) and the relationship to APTT×2 in an invitro assay. The longitudinal axis shows the concentration of thecompound in the plasma and the horizontal axis shows time after oraladministration.

FIG. 2 shows the change in the concentration of the compound in theplasma of the compound described in Example 4 (10) when being orallyadministered to rats (1 mg/kg) and the relationship to APTT×2 in an invitro assay. The longitudinal axis shows the concentration of thecompound in the plasma and the horizontal axis shows time after oraladministration,

FIG. 3 shows the change in the concentration of the compound in theplasma of the compound described in Comparative Example 2 (3) when beingorally administered to rats (1 mg/kg) and the relationship to APTT×2 inan in vitro assay. The longitudinal axis shows the concentration of thecompound in the plasma and the horizontal axis shows time after oraladministration.

DESCRIPTION OF EMBODIMENTS

The present invention will be described in details hereinbelow.

In the present invention, unless otherwise specified, the symbol:

represents that a substituent binds to the back side on the papersurface (in other words, α-configuration), the symbol:

represents that a substituent binds to the front side on the papersurface (in other words, β-configuration), and the symbol:

represents an arbitrary mixture of α-configuration and β-configuration,as would be apparent to those skilled in the art.

Unless otherwise specifically indicated, all isomers are included in thepresent invention. For example, an alkyl group includes linear andbranched ones. In addition, all of isomers due to the presence ofasymmetric carbon(s) and the like (R-, S-, α- and β-configurations,enantiomer(s) and diastereomer(s)), optically active substances havingoptical rotation (D-, L-, d- and l-forms), polar substances bychromatographic separation (more polar and less polar substances),compounds in equilibrium (for example, tautomers due to an amide bondand the like), rotational isomers, a mixture thereof in any proportionand a racemic mixture are included in the present invention.

Further, optical isomers in the present invention may include, not only100%-pure isomers, but also less than 50%-pure optical isomers.

The compound of the present invention can be converted into acorresponding salt by a known method. The salt is preferably apharmaceutically acceptable salt and is more preferably a water-solublesalt. Examples of the appropriate salt include an acid addition salt(such as a salt of an inorganic acid, for example, a hydrochloride, ahydrobromide, a hydroiodide, a sulfate, a phosphate and a nitrate aswell as a salt of an organic acid, for example, an acetate, a lactate, atartrate, a benzoate, a citrate, a methanesulfonate, an ethanesulfonate,a benzenesulfonate, a toluenesulfonate, an isethionate, a glucuronateand a gluconate), a salt of an alkali metal (such as potassium andsodium), a salt of an alkaline earth metal (such as calcium andmagnesium), an ammonium salt or a salt of a pharmaceutically acceptableorganic amine (such as tetramethylammonium, triethylamine, methylamine,dimethylamine, cyclopentylamine, benzylamine, phenethylamine,piperidine, monoethanolamine, diethanolamine,tris(hydroxymethyl)aminomethane, lysine, arginine andN-methyl-D-glucamine) and the like.

The compound of the present invention or a salt thereof can be alsoconverted into a solvate. The solvate is preferably a low-toxicity andwater-soluble solvate. Examples of the appropriate solvate include asolvate of water and a solvate of an alcohol based solvent (such as asolvate of ethanol).

An N-oxide of the compound of the present invention represents acompound obtained by oxidation of a nitrogen atom in the compound of thepresent invention. In addition, the N-oxide of the compound of thepresent invention may be further converted to the above-describedalkaline (alkaline earth) metal salt, the ammonium salt, the organicamine salt or the acid addition salt.

In addition, a prodrug of the compound of the present invention refersto a compound which is converted to the compound of the presentinvention by a reaction caused by an enzyme, gastric acid and the likein vivo, Specifically, examples of the prodrug of the compound of thepresent invention include a compound obtained by making an amino groupof the compound of the present invention be eicosanoylated, alanylated,pentylaminocarbonylated,(5-methyl-2-oxo-1,3-dioxolen-4-yl)methoxycarbonylated,tetrahydrofuranylated, pyrrolidylmethylated, pivaloyloxymethylated,acetoxymethylated, tert-butylated and the like. These compounds can beprepared by a known method. In addition, the prodrug of the compound ofthe present invention may be either a hydrate or a non-hydrate. Further,the prodrug of the compound of the present invention may be a compoundwhich is converted to the compound of the present invention under aphysiological condition as described in “Iyakuhin no kaihatsu(Pharmaceutical, research and development)”, Vol, 7, “Bunshi sekkei(Molecular Design)”, pages 163-198, Hirokawa-Shoten Ltd., published1990.

Furthermore, each atom constituting the compound of the presentinvention may also be replaced by an isotope (such as ²H, ³H, ¹³C, ¹⁴C,¹⁵N, ¹⁶N, ¹⁷O, ¹⁸O, ³⁵S, ³⁶Cl, ⁷⁷Br and ¹²⁵I) and the like.

The compound of the present invention can form a pharmaceuticallyacceptable cocrystal or cocrystalline salt. In this regard, thecocrystal or cocrystalline salt means a crystalline material which isconstituted by two or more kinds of unique solids at room temperatureeach having different physical characteristics (for example, thestructure, the melting point, the heat of fusion, the hygroscopicproperty, the solubility, the stability and the like). The cocrystal orcocrystalline salt can be prepared by a known method forcocrystallization per se.

[Processes for the Preparation of the Compound of the Present Invention]

The compound of the present invention can be prepared by a known method.For example, the compound of the present invention can be prepared byappropriately improving and combining the methods described hereinbelow,the methods described in Examples or the method described inComprehensive Organic Transformations: A Guide to Functional GroupPreparations 2nd Edition (Richard C. Larock, John Wiley & Sons Inc.,1999 and the like.

[Toxicity]

The toxicity of the compound of the present invention is sufficientlylow, and the compound of the present invention can be used as apharmaceutical safely.

[Application to Pharmaceuticals]

The compound of the present invention has a potent FXIa inhibitoryactivity. Accordingly, the compound of the present invention is usefulfor preventing and/or treating thromboembolic disease, for example,arterial cardiovascular thromboembolic disorder, venous cardiovascularthromboembolic disorder, arterial cerebrovascular thromboembolicdisorder, venous cerebrovascular thromboembolic disorder andthromboembolic disorder in the heart chamber or in the peripheralcirculation.

Examples of the arterial cardiovascular thromboembolic disorder includecoronary artery disease, ischemic cardiomyopathy, acute coronarysyndrome, coronary artery thrombosis, ischemic complications of unstableangina and non-Q wave myocardial infraction, ST-segment elevation and/ornon ST-segment elevation acute myocardial infarction which is medicallycared or involves percutaneous coronary intervention, angina pectorissuch as stable (exercise-induced) angina pectoris, variant anginapectoris, unstable angina, myocardial infarction (such as initialmyocardial infarction and recurrent myocardial infarction), acutemyocardial infarction, reocclusion and stenosis of a blood vessel aftercoronary artery bypass graft surgery, reocclusion and stenosis afterpercutaneous transluminal angioplasty, cardiac/transcoronary stentimplantation and after thrombolytic therapy for coronary artery,ischemic sudden death and the like.

Examples of the venous cardiovascular thromboembolic disease includedeep venous thrombosis (DVT) and/or pulmonary embolism (PE) in majorgeneral surgery, abdominal surgery, hip replacement arthroplasty, kneereplacement arthroplasty, hip fracture surgery, multiple bone fracture,multiple trauma, traumatic injury, spinal cord injury, burn injury or atthe time of entering critical care unit, DVT and/or PE in a patient withacute medical disease with a significantly limited physical activity,DVT and/or PE in a patient receiving cancer chemotherapy, DVT and/or PEin a patient with cerebral stroke, symptomatic or asymptomatic DVTregardless of the presence/absence of PE and the like.

Examples of the arterial cerebrovascular thromboembolic disorder includecerebral stroke, ischemic stroke, the acute phase of cerebralinfarction, cerebral stroke in a patient with nonvalvular atrialfibrillation or valvular atrial fibrillation, cerebral arterialthrombosis, cerebral infarction, transient ischemic attack (TIA),lacunar infarct, atherothrombotic cerebral infarction, cerebral arterialembolism, cerebral thrombosis, cerebrovascular disorder, asymptomaticcerebral infarction, vascular dementia and the like.

Examples of the venous cerebrovascular thromboembolic disorder includeintracranial venous thrombosis, cerebral embolism, cerebral thrombosis,cerebral venous sinus thrombosis, intracranial venous sinus thrombosis,cavernous sinus thrombosis and the like.

Examples of the thromboembolic disease in the heart chamber or in theperipheral circulation include venous thrombosis, systemic venousthromboembolism, recurrent venous thromboembolism, thrombophlebitis,nonvalvular and valvular atrial fibrillation, cardiogenic embolism,disseminated intravascular coagulation (DIC), sepsis, acute respiratorydistress syndrome (ARDS), acute lung injury (ALI), chronic obstructivepulmonary disease, antiphospholipid antibody syndrome, liver embolism,hepatic veno-occlusive disease (VOD), kidney embolism, renal veinthrombosis, renal artery occlusion, refractory nephrotic syndrome due tomembranous nephropathy or focal sclerosing glomerulonephritis, splenicvein thrombosis, superior mesenteric arterial occlusion, portal veinthrombosis, retinal vein occlusion, atherosclerosis, atherothrombosis,peripheral arterial occlusive disease (PROD), peripheral arterialdisease, arterial embolism, diabetes and metabolic syndrome as well assequelae thereof, thrombosis induced by the treatment in which blood isexposed to an artificial surface (such as a medical implant, a medicaldevice, a catheter, a stent, a prosthetic cardiac valve and ahemodialyzer) which promotes thrombus formation and the like.

Preferable examples of the thromboembolic disease include coronaryartery disease, unstable angina, acute coronary syndrome, atrialfibrillation, myocardial infarction (such as initial myocardialinfarction and recurrent myocardial infarction), ischemic sudden death,transient ischemic attack, cerebral stroke, peripheral arterial disease,atherosclerosis, peripheral occlusive arterial disease, venousthrombosis, venous thromboembolism, deep venous thrombosis,thrombophlebitis, arterial embolism, coronary artery thrombosis,cerebral arterial thrombosis, cerebral embolism, kidney embolism, portalvein thrombosis, pulmonary embolism, pulmonary infarction, liverembolism, hepatic veno-occlusive disease (VOD)/sinusoidal obstructionsyndrome (SOS), thrombotic microangiopathy (TMA), disseminatedintravascular coagulation (DIC), sepsis, acute respiratory distresssyndrome (ARDS), acute lung injury (ALI), antiphospholipid antibodysyndrome, thrombosis due to coronary artery bypass graft surgery,thrombosis induced by the treatment in which blood is exposed to anartificial surface (such as a medical implant, a medical device, acatheter, a stent, a prosthetic cardiac valve and a hemodialyzer) whichpromotes thrombus formation and the like.

In the present specification, atrial fibrillation, atherosclerosis orsepsis includes thromboembolic disease induced by atrial fibrillation,atherosclerosis or sepsis.

More preferable examples of the thromboembolic disease include venousthromboembolism (VTE), ischemic stroke, thromboembolic disease inducedby the treatment in which blood is exposed to an artificial surfacewhich promotes thrombus formation, acute coronary syndrome, coronaryartery disease, peripheral arterial disease and the like.

The venous thromboembolism (VTE) includes deep venous thrombosis (DVT),pulmonary embolism (PE) and Pulmonary embolism which involves deepvenous thrombosis. The prevention and/or treatment of the VTE includesthe onset inhibition of VTE in a patient receiving an orthopedic surgeryof lower extremity (such as total knee replacement arthroplasty, totalhip replacement and operation of hip fracture), the onset inhibition ofDVT and/or PE in a patient with acute medical disease with asignificantly limited physical activity, the intraoperative and/orpostoperative onset inhibition of VTE in a patient receiving abdominalsurgery and the onset inhibition of DVT and/or PE in a patient receivingcancer chemotherapy.

The prevention and/or treatment of the ischemic stroke includes theonset inhibition of ischemic stroke and systemic embolism in a patientwith nonvalvular atrial fibrillation, the onset inhibition of recurrentcerebral stroke and systemic embolism in a patient with embolic strokeof undetermined source (ESUS), the onset inhibition of ischemic strokeand systemic embolism in a patient with atrial fibrillation associatedwith acute coronary syndrome (ACS), the onset inhibition of ischemicstroke and systemic embolism in a patient with atrial fibrillation withchronic kidney disease (CKD) or end-stage renal disease and theinhibition of recurrence of ischemic stroke (excepting cardiogenicembolism).

The prevention and/or treatment of the thromboembolic disease induced bythe treatment in which blood is exposed to an artificial surface whichpromotes thrombus formation includes the prevention and/or treatment ofthromboembolic disease in a patient receiving prosthetic replacement,the prevention and/or treatment of thromboembolic disease in a patientwith installation of a ventricular assist device such as an implantableventricular assist device, a total replacement type ventricular assistdevice, a percutaneous ventricular assist device and an extracorporealventricular assist device and the prevention and/or treatment ofthromboembolic disease in a patient with an indwelled coronary arterystent.

The prevention and/or treatment of the acute coronary syndrome (ACS),coronary artery disease or peripheral arterial disease includes theinhibition of a cardiovascular event in a patient with acute coronarysyndrome (ACS), the inhibition of a cardiovascular event in a patientwith coronary artery disease or peripheral arterial disease and theinhibition of a cardiovascular event in a patient with diabetes with ahigh cardiovascular risk (more preferably, in a patient with type 2diabetes).

In addition, the compound of the present invention has a plasmakallikrein inhibitory action, and therefore, is useful for preventingand/or treating disease associated with plasma kallikrein.

Examples of the disease associated with plasma kallikrein includeretinopathy, diabetic retinopathy, hypertensive retinopathy,proliferative and nonproliferative retinopathy, age-related maculardegeneration (AMD), disorder related to the prevention and/or treatmentof hematoma or increased vascular permeability, disease related toedema, hereditary angioedema (RAE), diabetic macular edema (DME),clinically significant macular edema (CSME), cystoid macular edema(CME), retinal edema, edema related to neuroglia, cerebral edema,lymphedema, angioedema, traumatic brain injury, hemorrhagic stroke,intracerebral hemorrhage, cerebral aneurysm, arteriovenous malformation,spinal cord injury, ischemia-reperfusion injury, ischemia, cerebralischemia, pain, disorder accompanied with elements of inflammation,encephalitis, multiple sclerosis, pruritus, arthritis, inflammatorybowel disease, gout, psoriasis, disease related to activation ofstellate cells, Alzheimer's disease, Parkinson's disease, amyotrophiclateral sclerosis, Creutzfeldt-Jakob disease, epilepsy, essentialhypertension, hypertension related to diabetes or hyperlipidemia, renalfailure, chronic kidney disease, heart failure, proteinuria, blood lossduring surgery and the like.

Preferable examples of the disease associated with plasma kallikreininclude disease related to edema, hereditary angioedema, macular edema,cerebral edema, retinopathy, formation of edema related toischemia-reperfusion injury as well as blood loss during surgery such ascardiopulmonary bypass and coronary artery bypass grafting.

When the compound of the present invention is applied to apharmaceutical, the compound of the present invention may be used notonly as a single agent, but also as a combined medicine by beingcombined with other active ingredient(s), for example, agent(s) and thelike which are listed hereinbelow for the purpose, for example, of:

(1) complementation and/or enhancement of the effects of preventing,treating and/or ameliorating symptoms,

(2) improvement in the kinetics or absorption, and reduction of thedose, and/or

(3) reduction of the side effects.

When the compound of the present invention is used for preventing and/ortreating thromboembolic disease, examples of combined agent(s) which isused in combination with the compound of the present invention includean anticoagulant agent, an antiplatelet agent, a thrombolytic agent, afibrinolytic agent, a serine protease inhibitor, an elastase inhibitor,a steroid, a combination thereof and the like.

Examples of the anticoagulant agent include a thrombin inhibitor, anantithrombin III activator, a heparin cofactor II activator, other FXIainhibitors, a plasma and/or tissue kallikrein inhibitor, an inhibitor ofplasminogen activator inhibitor (PAI-1), an inhibitor ofthrombin-activatable fibrinolysis inhibitor (TAFI), a factor Vilainhibitor, a factor Villa inhibitor, a factor. IXa inhibitor, a factorXa inhibitor, a factor XIIa inhibitor, a combination thereof and thelike.

Examples of the antiplatelet agent include a GPII/IIIa blocker, aprotease-activated receptor (PAR-1) antagonist, a PAR-4 antagonist, aphosphodiesterase III inhibitor, other phosphodiesterase inhibitors, aP2X1 antagonist, a P2Y1 receptor antagonist, a P2Y12 antagonist, athromboxane receptor antagonist, a thromboxane A2 synthetase inhibitor,a cyclooxygenase-1 inhibitor, a phospholipase D1 inhibitor, aphospholipase D2 inhibitor, a phospholipase D inhibitor, a glycoproteinVI (GPVI) antagonist, a glycoprotein Ib (GPIB) antagonist, a GAS6antagonist, aspirin, a combination thereof and the like.

Preferably, the combined agent is an antiplatelet agent.

Preferable examples of the antiplatelet agent include clopidogrel,prasugrel, ticagrelor, cangrelor, elinogrel, cilostazol, sarpogrelate,iloprost, beraprost, limaprost and/or aspirin, a combination thereof andthe like.

Preferably, the combined agent is warfarin, unfractionated heparin,low-molecular-weight heparin, enoxaparin, dalteparin, bemiparin,tinzaparin, semuloparin sodium (AVE-5026), danaparoid, a synthesizedpentasaccharide, fondaparinux, hirudin, disulfatohirudin, lepirudin,bivalirudin, desirudin, argatroban, aspirin, ibuprofen, naproxen,sulindac, indomethacin, mefenamate, droxicam, diclofenac,sulfinpyrazone, piroxicam, ticlopidine, clopidogrel, prasugrel,ticagrelor, cangrelor, elinogrel, cilostazol, sarpogrelate, iloprost,beraprost, limaprost, tirofiban, eptifibatide, abciximab, melagatran,ximelagatran, dabigatran, rivaroxaban, apixaban, edoxaban, darexaban,betrixaban, TAK-442, tissue plasminogen activator, a modified tissueplasminogen activator, anistreplase, urokinase, streptokinase, gabexate,gabexate mesilate, nafamostat, sivelestat, sivelestat sodium hydrate,alvelestat (AZD-9668), ZD-8321/0892, 101-200880, human elafin(tiprelestat), elafin, α1-antitrypsin (A1AT), cortisone, betamethasone,dexamethasone, hydrocortisone, methylprednisolone, prednisolone,triamcinolone or a combination thereof.

In another embodiment, examples of the combined agent in the presentinvention include a potassium channel opener, a potassium channelblocker, a calcium channel blocker, an inhibitor of sodium-hydrogenexchanger, an antiarrhythmic agent, an antiarteriosclerotic agent, ananticoagulant agent, an antiplatelet agent, an antithrombotic agent, athrombolytic agent, a fibrinogen antagonist, an antihypertensivediuretic, an ATPase inhibitor, a mineralocorticoid receptor antagonist,a phosphodiesterase inhibitor, an antidiabetic agent, a proteaseinhibitor, an elastase inhibitor, an anti-inflammatory agent, anantioxidant, an angiogenesis-modulating agent, an agent for treatingosteoporosis, hormone replacement therapy, a hormone receptor-modulatingagent, an oral contraceptive, an anti-obesity drug, an antidepressantdrug, an antianxiety agent, an antipsychotic agent, an antiproliferativeagent, an antitumor agent, antiulcer and antigastroesophageal refluxagents, a growth hormone agent and/or a growth hormone secretagogue, athyroid-mimetic, an anti-infective agent, an antiviral agent, anantimicrobial agent, an antifungal agent, a drug for treatinghypercholesterolemia/dyslipidemia and therapy for improving lipidprofile, preconditioning of simulated ischemia and/or an agent forstunned myocardium, a combination thereof and the like.

In another embodiment, examples of the combined agent in the presentinvention further include an antiarrhythmic agent, an antihypertensiveagent, an anticoagulant agent, an antiplatelet agent, a thrombolyticagent, a fibrinolytic agent, a calcium channel blocker, a potassiumchannel blocker, a cholesterol/lipid-lowering agent, a serine proteaseinhibitor, an elastase inhibitor, an anti-inflammatory agent, acombination thereof and the like.

Examples of the antiarrhythmic agent include an IKur inhibitor, anelastase inhibitor, a serine protease inhibitor, a steroid and the like.

Examples of the antihypertensive agent include an ACE inhibitor, an AT-1receptor antagonist, a (3-adrenergic receptor antagonist, an ETAreceptor antagonist, a dual ETA/AT-1 receptor antagonist, avasopeptidase inhibitor and the like.

In a preferable embodiment, examples of the combined agent in thepresent invention include an antiplatelet agent and a combinationthereof.

The combined medicine of the compound of the present invention with theabove-described other agent(s) may be administered in the form of acompounding agent in which both ingredients are compounded in apreparation or may be administered in the form of separate preparationsby the same route of administration or different routes ofadministration. When the separate preparations are administered, thepreparations are not necessarily administered concomitantly, but asneeded, each of the preparations may be administered with a timedifference. In addition, in the case of the administrations with a timedifference, the order of administrations is not particularly limited,but may be appropriately adjusted in order to achieve the desired drugefficacy.

The dose of the above-described other agent(s) which is used incombination with the compound of the present invention can beappropriately increased or decreased based on the clinically used doseof the agent(s) or an agent similar thereto. In addition, the compoundedratio of the compound of the present invention and other agent(s) can beappropriately adjusted by considering the age and body weight of thesubject of administration, the method for administration, the durationof administration, the target disease, the symptom and the like.Approximately 0.01 to 100 parts by weight of other agent(s) may becombined with 1 part by weight of the compound of the present invention.Two or more kinds of other agent(s) may be used. In addition, examplesof the other agent(s) include not only those listed above, but alsodrug(s) having the same mechanism as those listed above. The drug(s)having the same mechanism as those listed above includes not only thosewhich have been found up to now but also those which will be found infuture.

The compound of the present invention is normally administeredsystemically or locally, in the form of an oral preparation or aparenteral preparation. Examples of the oral preparation include an oralliquid preparation (such as an elixir, a syrup, a pharmaceuticallyacceptable liquid agent, a suspension and an emulsion), an oral solidpreparation (such as a tablet (including a sublingual tablet and anorally disintegrating tablet), a pill, a capsule (including a hardcapsule, a soft capsule, a gelatin capsule and a microcapsule), apowdered agent, a granule and a lozenge) and the like. Examples of theparenteral preparation include a liquid preparation (such as aninjection preparation (such as an intravitreal injection preparation, asubcutaneous injection preparation, an intravenous injectionpreparation, an intramuscular injection preparation, an intraperitonealinjection Preparation and a preparation for drip infusion), an eye drop(such as an aqueous eye drop (such as an aqueous ophthalmic solution, anaqueous ophthalmic suspension, a viscous eye drop and a solubilized eyedrop) and a non-aqueous eye drop (such as a non-aqueous ophthalmicsolution and a non-aqueous ophthalmic suspension))), an externalpreparation (such as an ointment (such as an ophthalmic ointment)), anear drop and the like. The above-described preparation may be acontrolled-release preparation such as an immediate-release preparationand a sustained release preparation. The above-described Preparation canbe prepared by a known method, for example, by a method described inPharmacopeia of Japan or the like.

The oral liquid preparation as an oral preparation is prepared, forexample, by dissolving, suspending or emulsifying an active ingredientin a generally used diluent (such as purified water, ethanol and a mixedliquid thereof). In addition, the liquid preparation may further containa wetting agent, a suspending agent, an emulsifying agent, a sweeteningagent, a flavoring agent, a perfume, a preservative, a buffer agent andthe like.

The oral solid preparation as an oral preparation is prepared, forexample, by mixing an active ingredient with an excipient (such aslactose, mannitol, glucose, microcrystalline cellulose and starch), abonding agent (such as hydroxypropyl cellulose, polyvinylpyrrolidone andmagnesium aluminometasilicate), a disintegrating agent (such as calciumcellulose glycolate), a lubricant (such as magnesium stearate), astabilizer, a solubilizing agent (such as glutamic acid and asparticacid) and the like by a routine procedure. In addition, if necessary,the active ingredient may be coated with a coating agent (such as whitesoft sugar, gelatin, hydroxypropyl cellulose and hydroxypropylmethylcellulose phthalate) or may be coated with two or more layers.

The external preparation as a parenteral preparation is prepared by aknown method or according to a normally used formulation. For example,an ointment is prepared by triturating or melting an active ingredientin a base. An ointment base is selected from those which are known andthose which are normally used. For example, one selected from thefollowings is used or two or more kinds selected from the followings areused by being mixed together: a higher fatty acid or a higher fatty acidester (such as adipic acid, myristic acid, palmitic acid, stearic acid,oleic acid, an adipate, a myristate, a palmitate, a stearate and an,oleate), waxes (such as beeswax, whale wax and ceresin), asurface-active agent (such as a polyoxyethylene alkyl ether phosphoricester), a higher alcohol (such as cetanol, stearyl alcohol andcetostearyl alcohol), a silicone oil (such as dimethyl polysiloxane),hydrocarbons (such as hydrophilic petrolatum, white petrolatum, purifiedlanolin and liquid paraffin), glycols (such as ethylene glycol,diethylene glycol, propylene glycol, polyethylene glycol and macrogel),a vegetable oil (such as castor oil, olive oil, sesame oil andturpentine oil), an animal oil (such as mink oil, egg-yolk oil, squalaneand squalene), water, an absorption promoter and an agent for preventingskin rash. In addition, a moisturizing agent, a preservative, astabilizing agent, an antioxidant, a flavoring agent and the like may becontained.

The injection preparation as a parenteral preparation includes asolution, a suspension, an emulsion and a solid injection preparationwhich is used at the time of use by being dissolved or suspended in asolvent. The injection preparation is used, for example, by dissolving,suspending or emulsifying an active ingredient in a solvent. Examples ofthe solvent used include distilled water for injection, saline, avegetable oil, alcohols such as propylene glycol, polyethylene glydoland ethanol and the like as well as a mixture thereof. In addition, theinjection preparation may contain a stabilizer, a solubilizing agent(such as glutamic acid, aspartic acid and polysorbate 80 (registeredtrademark)), a suspending agent, an emulsifying agent, an analgesic, abuffer agent, a preservative and the like. The above-described injectionpreparation is prepared by being sterilized at the final process or byan aseptic manipulation method. In addition, the above-describedinjection preparation can be also used by preparing a sterile solidpreparation, for example, a lyophilized preparation, and dissolving thesterile solid preparation in sterilized or sterile distilled water forinjection or other solvent before use of the preparation.

In order to use the compound of the present invention or the combinedmedicine of the compound of the present invention with other agent(s)for the above-described purpose, the compound of the present inventionor the combined medicine of the compound of the present invention withother agent(s) is normally administered systemically or locally, in theform of an oral preparation or a parenteral preparation. The dose variesdepending on the age, the body weight, the symptom, the therapeuticeffect, the method for administration, the duration of the treatment andthe like. However, normally, the dose per adult is in the range of from1 ng to 1,000 mg per administration, from one to several oraladministrations per day or the dose per adult is in the rage of from 0.1ng to 10 mg per administration, from one to several parenteraladministrations per day.

Alternatively, the dose is continuously administrated intravenously fora period of time in the range of 1 to 24 hours per day. Of course, thedose varies depending on various factors as described above, andtherefore, there are some cases in which a dose below theabove-described dose is sufficient and there are other cases in whichadministration of a dose which exceeds the above-described range isrequired.

EXAMPLES

The present invention will be described in details by referring toExamples hereinbelow, but the present invention is not limited toExamples.

Concerning chromatographic separation or TLC, a solvent in parenthesescorresponds to an eluting solvent or a developing solvent employed and aratio is expressed by volume ratio.

Concerning NMR, a solvent in parentheses corresponds to a solvent usedfor the measurement.

A compound name used in the present specification is given by using acomputer program ACD/Name (registered trademark) of Advanced ChemistryDevelopment which generally denominates a compound according to theIUPAC nomenclature or by denomination according to the IUPACnomenclature.

The measuring time, solvents and column conditions used for LC/MSanalyses in the following Examples are shown hereinbelow. Meanwhile,t_(R) means Retention time. Condition a, column YMC-Triart C18, 2.0mm×30 mm, 1.9 μm; column temperature 30° C.; mobile phase (Liquid A)0.1% trifluoroacetic acid aqueous solution and (Liquid B) 0_1%trifluoroacetic acid-acetonitrile solution; flow rate 1.0 mL/min;analysis time 1.5 minutes; gradient: 0 minute (Liquid A/Liquid B=95/5),0.1 minutes (Liquid A/Liquid B=95/5), 1.2 minutes (Liquid A/LiquidB=5/95), 1.4 minutes (Liquid A/Liquid B=5/95), 1.41 minutes (LiquidA/Liquid B=95/5), 1.5 minutes (Liquid A/Liquid B 95/5)

Condition b. column Waters ACQUITY UPLC (registered trademark) BEH C18,2-1 mm×30 mm, 1.7 μm; column temperature 40° C.; mobile phase (Liquid A)0.1% formic acid aqueous solution and (Liquid B) 0.1% formicacid-acetonitrile solution; flow rate 1.0 mL/min; analysis time 1.5minutes; gradient: 0 minute (Liquid A/Liquid B 95/5), 0.1 minutes(Liquid A/Liquid B=95/5), 1.2 minutes (Liquid A/Liquid B=5/95), 1.4minutes (Liquid A/Liquid B 5/95), 1.41 minutes (Liquid A/Liquid B 95/5),1.5 minutes (Liquid A/Liquid B=95/5).

EXPERIMENTAL EXAMPLES Example 1 (1) 2-methyl-2-propanyl(6-fluoro-5-iodo-2-pyridinyl)carbamate

To a solution of 6-fluoro-5-iodopyridin-2-amine (17 g) in acetonitrile(150 mL), di-tert-butyl dicarbonate (17.14 g) and4-dimethylaminopyridine (0.87 g) were added, and the mixture was stirredat room temperature for 2 hours. Further, to the mixture, di-tert-butyldicarbonate (7.8 g) was added, and the mixture was stirred at roomtemperature for additional 2 hours. To the reaction mixture, saturatedammonium chloride aqueous solution and ethyl acetate were added, andinsoluble matters were removed. The combined organic layers were washedwith saturated saline, were dried, and thereafter, were concentrated.The residue was purified by two kinds of column chromatography (ethylacetate:hexane=0:100 to 25:75), (aminosilica, ethyl acetate:hexane=10:90to 50 50) to give the title compound (9.2 g) having the followingphysical property.

TLC: Rf 0.69 (ethyl acetate:hexane=25:75).

Example 1 (2): 2-methyl-2-propanyl[5-(1-ethoxyvinyl)-6-fluoro-2-pyridinyl]carbamate

To a solution (200 mL) of the compound (40 g) prepared in Example 1 (1)in N,N-dimethylformamide, tributyl(1-ethoxyethenyl)tin (50 g) was added.The mixture was deaerated with argon, and to the mixture,tetrakis(triphenylphosphine)palladium (0) (3.24 g) was added, and themixture was stirred at 100° C. for 16 hours. The reaction mixture wasdiluted with ethyl acetate (200 mL), and was poured into 1 M potassiumfluoride aqueous solution (500 mL), The mixture was stirred for 30minutes, and thereafter, was filtrated through Celite (registeredtrademark), and the filtrate was extracted with ethyl acetate. Thecombined organic layers were washed with water and saturated saline,were dried, and thereafter, were concentrated. The residue was purifiedby column chromatography (aminosilica, ethyl acetate:hexane=3:97 to5:95) to give the title compound (34.4 g) having the following physicalproperties.

LC/MS t_(R) 1.15 minutes: MS (ES⁺) m/z 227 [M-CH₂C(CH₃)₂)+H] (Conditiona).

Example 1 (3): 2-methyl-2-propanyl[5-(bromoacetyl)-6-fluoro-2-pyridinyl]carbamate

The compound (34.4 g) prepared in Example 1 (2) was dissolved intetrahydrofuran (150 mL) and water (50 mL), and to the mixture,N-bromosuccinimide (21.7 g) was added under ice cooling. The mixture wasstirred for 30 minutes under ice cooling, and thereafter, was dilutedwith ethyl acetate, and was washed twice with saturated sodiumbicarbonate aqueous solution. The organic layer was washed withsaturated saline, was dried, and thereafter, was concentrated. Theresidue was purified by column chromatography (ethylacetate:hexane=10:90 to 30:70) to give the title compound (27.58 g)having the following physical property.

TLC: Rf 0.26 (ethyl acetate:hexane=10:90).

Example 1 (4): 2-methyl-2-propanyl[5-(2-{(3S)-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinyl}-1H-imidazol-5-yl)-6-fluoro-2-pyridinyl]carbamate

To a solution (200 mL) of(3S)-7-[5-chloro-2-(1H-1,2,3,4-tetrazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydroindolizine-3-carboxylicacid (described in Example 9 of Patent Literature 6) (27.58 g) and thecompound (25.68 g) prepared in Example 1 (3) in N-methylpyrrolidone,N,N-diisopropylethylamine (26.7 mL) was added under ice cooling. Themixture was stirred at room temperature for 30 minutes, and thereafter,the reaction mixture was diluted with ethyl acetate (200 mL) and waswashed with saturated ammonium chloride aqueous solution (500 mL), Theaqueous layer was extracted with ethyl acetate, and the combined organiclayers were washed with water (500 mL) and saturated saline (500 mL),were dried, and thereafter, were concentrated. The residue was dissolvedin toluene (500 mL) and glacial acetic acid (50 mL), and to the mixture,ammonium acetate (59.4 g) was added, and the mixture was stirred at 100°C. for 3 hours. The mixture was concentrated under reduced Pressure, wasdiluted with ethyl acetate, and was washed with saturated potassiumcarbonate aqueous solution (500 mL). The aqueous layer was extractedwith ethyl acetate, and the combined organic layers were dried, andthereafter, were concentrated. The residue was purified by columnchromatography (ethyl acetate:hexane=50:50 to 100:0) to give the titlecompound (33.5 g) having the following physical properties.

LC/MS t_(R) 0.84 minutes: MS (ES⁺) m/z 590 (M+H) (Condition a).

Example 1 (5): 2-methyl-2-propanyl[5-(2-{(3S)-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinyl}-4-fluoro-1H-imidazol-5-yl)-6-fluoro-2-pyridinyl]carbamate

The compound (350 mg) prepared in Example 1 (4) was dissolved intetrahydrofuran (1.2 mL) and acetonitrile (3.6 mL), and to the mixture,pyridine (0.14 mL) was added, and to the mixture,1-chloromethyl-4-fluoro-1,4-diazoniabicyclo[22.2]octanebis(tetrafluoroborate) (315 mg) was added at −18° C., and the mixturewas stirred for 2 hours. The reaction mixture was diluted with ethylacetate, and sodium sulfite aqueous solution was added, and the mixturewas stirred. Water was added to the mixture, and the mixture wassubjected to liquid separation, and the aqueous layer was extracted withethyl acetate. The organic layers were combined, and the combinedorganic layers were washed with hydrochloric acid, saturated sodiumbicarbonate aqueous solution and saturated saline, were dried, andthereafter, were concentrated. The residue was purified by columnchromatography (ethyl acetate:hexane=30:70 to 100:0) to give the titlecompound (138 mg) having the following physical property.

TLC: Rf 0.51 (ethyl acetate:hexane 80:20).

Example 1 (6):(3S)-3-[5-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H-imidazol-2-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone

To a solution (100 mL) of the compound (12.2 g) prepared in Example 1(5) in 1,4-dioxane, concentrated hydrochloric acid (5 mL) was added, andthe mixture was stirred at 40° C. for 1 hour. Additional concentratedhydrochloric acid (5 mL) was added, and the mixture was stirred for 1hour and 30 minutes, and thereafter, the mixture was concentrated. Theresidue was diluted with ethyl acetate, and was washed with saturatedsodium carbonate aqueous solution. The aqueous layer was extracted with17% methanol/ethyl acetate, and the combined organic layers were dried,and thereafter, were concentrated. The residue was purified by columnchromatography (methanol:ethyl acetate=5:95 to 10:90) to give the titlecompound (8.27 g) having the following physical properties.

TLC: Rf 0.48 (ethyl acetate);

¹H-NMR (CD₃OD): δ 9.34 (s, 1H), 7.76-7.62 (m, 4H), 6.45 (dd, 1H), 6.13(s, 1H), 6.07 (s, 1H), 5.71 (d, 1H), 3.42 (m, 1H), 3.06 (m, 1H), 2.58(m, 1H), 2.42 (m, 1H).

Example 2 (1): 6-Fluoro-5-iodo-2-pyridinamine

N-iodosuccinimide (56.5 g) was added in multiple portions (3 portions)to a solution of 6-fluoro-2-pyridinamine (25.6 g) inN,N-dimethylformamide (200 mL) under ice cooling. The mixture wasstirred at room temperature for 3 hours, and thereafter, to the reactionliquid, city water (0.5 L) was added. The mixture was extracted threetimes with ethyl acetate/hexane (1/1, 300 mL), and the organic layer waswashed with saturated sulfurous acid aqueous solution (0.5 L), saturatedsodium carbonate aqueous solution (0.5 L, twice), city water (0.5 L) andsaturated saline (0.5 L), was dried, and thereafter, was concentrated.To the obtained residue, hexane/ethyl acetate (3/1, 150 mL) was added,and the slurry was washed at room temperature, and was filtrated. Theobtained solid was dried to give the title compound (36.7 g) having thefollowing physical property.

TLC: Rf 0.56 (ethyl acetate:hexane=1:2).

Example 2 (2): Bis(2-methyl-2-propanyl)(6-fluoro-5-iodo-2-pyridinyl)imidodicarbonate

To a solution of the compound (36.7 g) prepared in Example 2 (1) and4-dimethylaminopyridine (0.9 g) in acetonitrile (300 mL), a solution ofdi-tert-butyl dicarbonate (74.0 g) in acetonitrile (100 mL) was added,and the mixture was stirred at room temperature for 3 hours. Thereaction solution was concentrated, and the obtained residue wasdissolved in ethyl acetate (500 mL), and the mixture was washed withsaturated ammonium chloride aqueous solution (400 mL), and the aqueouslayer was extracted with ethyl acetate (200 mL). The combined organiclayers were dried, and thereafter, were concentrated. The obtainedresidue was purified by silica gel column chromatography (ethylacetate:hexane=5:95 to 10:90) to give the title compound (45.06 g)having the following physical properties.

¹H-NMR (CDCl₃): δ 8.14 (t, 1H), 7.03 (dd, 1H), 1.47 (s, 18H).

Example 2 (3) 2-methyl-2-propanyl(5-cyano-6-fluoro-2-pyridinyl)carbamate

A solution of the compound (9.1 g) prepared in Example 2 (2), zinc (II)cyanide (7.32 g) and tetrakis(triphenylphosphine)palladium (0) (1.2 g)in 1-methyl-2-pyrrolidinone (60 mL) was deaerated under reducedpressure. Under microwave irradiation, the mixture was stirred at 130°C. for 1 hour, and thereafter, was left to cool. The reaction solutionwas diluted with ethyl acetate (100 mL), and thereafter, was filtratedthrough Celite to remove insoluble matters, and the insoluble matterswere washed with ethyl acetate (50 mL). The filtrate was subjected toliquid separation, and the aqueous layer was extracted again with ethylacetate (100 mL). The organic layers were combined, were dried, andthereafter, were concentrated. The obtained residue was purified bysilica gel column chromatography (ethyl acetate:hexane=5:95 to 80:20) togive the title compound (2.1 g) having the following physical property.

TLC: Rf 0.25 (ethyl acetate:hexane=10:90).

Example 2 (4): 2-methyl-2-propanyl[6-fluoro-5-(N-hydroxycarbamimidoyl)-2-pyridinyl]carbamate

To a solution of the compound (1.56 g) prepared in Example 2 (3) andhydroxylamine hydrochloride (0.91 g) in ethanol (40 mL),N,N-diisopropylethylamine (2084 mL) was added, and the mixture wasstirred at 40° C. overnight. The reaction solution was concentrated, andthe obtained residue was dissolved in ethyl acetate (50 mL). To themixture, city water (50 mL) was added to wash, and thereafter, theorganic layer was dried, and thereafter, was concentrated to give thecrude title compound (1.93 g) having the following physical properties.

LC/MS t_(R) 0.60 minutes; MS (ES+) m/z 272 (M+H) (Condition a).

Example 2 (5): 2-methyl-2-propanyl(5-carbamimidoyl-6-fluoro-2-pyridinyl)carbamate acetate

To a solution of the compound (1.93 g) prepared in Example 2 (4) inacetic acid (10 mL), acetic anhydride (0.75 mL) was added, and themixture was stirred at room temperature for 1 hour. To the reactionliquid, palladium (II) hydroxide (20%, 250 mg) was added, and themixture was stirred under hydrogen atmosphere at room temperature for 3hours. The reaction liquid was filtrated through Celite, and thefiltrate was concentrated under reduced pressure to give the crude titlecompound (2.99 g) having the following physical properties.

LC/MS to 0.59 minutes; MS (ES+) m/z 255 (M+H) (Condition a).

Example 2 (6): 2-methyl-2-propanyl(5-carbamimidoyl-6-fluoro-2-pyridinyl)carbamate hydrochloride

To a solution of the compound (2.6 g) prepared in Example 2 (5) inmethanol (10 mL), 10% hydrogen chloride/methanol (6.5 mL) solution wasadded, and the mixture was stirred at room temperature for 10 minutes.To the reaction liquid, toluene was added, and the mixture wasconcentrated to give the crude title compound (2.63 g) having thefollowing physical properties.

LC/MS t_(R) 0.58 minutes; MS (ES+) m/z 255 (M+H) (Condition a).

Example 2 (7):(3S)-3-(chloroacetyl)-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone

To a solution of(3S)-7-[5-chloro-2-(1H-1,2,3,4-tetrazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydroindolizine-3-carboxylicacid (described in Example 9 of Patent Literature 6) (3.0 g) indichloromethane (15 mL), 1-chloro-N,N,2-trimethyl-1-propen-1-amine (1.33mL) was added under ice cooling, and the mixture was stirred at 0° C.for 40 minutes. To the mixture, trimethylsilyldiazomethane (2 M hexanesolution, 8.4 mL) was added, and thereafter, the mixture was stirred at0° C. for additional 1 hour. To the mixture, concentrated hydrochloricacid (0.87 mL) was added under ice cooling, and the mixture was stirredat room temperature for 20 minutes. To the reaction liquid, city water(50 mL) was added, and the mixture was extracted twice withdichloromethane (50 mL), The organic layer was dried, and thereafter,was concentrated, and the obtained residue was purified by silica gelcolumn chromatography (ethyl acetate:hexane=40:60 to 100:0) to give thetitle compound (2.32 g) having the following physical properties.

LC/MS t_(R) 0.80 minutes; MS (ES+) m/z 390 (M+H) (Condition a).

Example 2 (8): 2-methyl-2-propanyl[5-(5-{7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinyl}-1H-imidazol-2-yl)-6-fluoro-2-pyridinyl]carbamate

To a solution of the compound (1.5 g) prepared in Example 2 (6) and thecompound (1.0 g) prepared in Example 2 (7) in acetonitrile (50 mL),potassium carbonate (0.70 g) was added, and the mixture was stirred at80° C. for 17 hours. The reaction solution was diluted with ethylacetate (100 mL), and thereafter, the solution was washed with citywater (100 mL) and saturated saline (200 mL), was dried, and thereafter,was concentrated. The obtained residue was purified by silica gel columnchromatography (ethyl acetate:hexane=50:50 to 100:0, followed bymethanol:ethyl acetate=5:95) to give the title compound (1.11 g) havingthe following physical properties.

LC/MS t_(R) 0.81 minutes; MS (ES+) m/z 590 (M+H) (Condition a).

Example 2 (9): 2-methyl-2-propanyl[5-(5-{(3S)-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinyl}-4-fluoro-1H-imidazol-2-yl)-6-fluoro-2-pyridinyl]carbamateand 2-methyl-2-propanyl[5-(5-{(3R)-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinyl}-4-fluoro-1H-imidazol-2-yl)-6-fluoro-2-pyridinyl]carbamate

To a suspension of the compound (264 mg) prepared in Example 2 (8) andsodium carbonate (118 mg) in acetonitrile (10 mL)/tetrahydrofuran (5mL), 1-chloromethyl-4-fluoro-1,4-diazoniabicyclo[2,2,2]octanebis(tetrafluoroborate) (selectfluor (registered trademark)) (95 mg) wasadded, and the mixture was stirred under cooling in an ice/brine bathfor 3 hour. The reaction solution was diluted with ethyl acetate (20mL), and to the solution, sodium sulfite aqueous solution (40 mL) wasadded. The aqueous layer was extracted twice with ethyl acetate (50 mL),and the combined organic layers were dried, and thereafter, wereconcentrated. The obtained residue was purified by silica gel columnchromatography (aminosilica, ethyl acetate:hexane=50:50 to 100:0,followed by methanol:ethyl acetate=5:95) to give the mixture (71.2 mg)of the S-configuration compound and the R-configuration compound ofExample 2 (9). The obtained mixture (20 mg) was purified by the opticalresolution (DAICEL, CHIRALFLASH (registered trademark) IC column,(particle size: 20 μm; column length: 100×30 mm I.D.), flow rate: 24mL/min; column temperature: room temperature; mobile phase (A):acetonitrile; mobile phase (B): methanol; isocratic (mobile phase(A):mobile phase (B)=90:10), 20 minutes; detector: UV Yamazen UV-254WUV-Detector) to give the title compounds (the S-configuration compoundof Example 2 (9): 7.9 mg, and the R-configuration compound of Example 2(9): 7.7 mg), Meanwhile, when the optical resolution was conducted underthe above-described conditions, the retention times of the titlecompounds were 13 minutes (the S-configuration compound of Example 2(9)) and 9.5 minutes (the R-configuration compound of Example 2 (9)),respectively.

The physical properties of each of the title compounds when beinganalyzed under liquid chromatographic conditions in parentheses beloware shown hereinbelow.

The S-configuration compound of Example 2 (9):LC t_(R) 10.4 minutes (column: DAICEL CHIRALPAK (registered trademark)IC 5 μm 4.6 mm×250 mm, mobile phase: acetonitrile/methanol=90/10, flowrate: 1.0 mL/min).The R-configuration compound of Example 2 (9):LC t_(R) 7.95 minutes (column: DAICEL CHIRALPAK (registered trademark)IC 5 μm 4.6 mm×250 mm, mobile phase:acetonitrile/methanol=90/10, flowrate: 1.0 mL/min).

Example 2 (10):(3S)-3-[2-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H-imidazol-5-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone

To a suspension of the S-configuration compound (436 mg) of Example 2(9) in ethyl acetate (6 mL), concentrated hydrochloric acid. (2 mL) wasadded, and the mixture was stirred at room temperature for 20 minutes.The reaction solution was concentrated under reduced pressure, and theobtained residue was redissolved in tetrahydrofuran (10 mL), To thesolution, saturated sodium bicarbonate aqueous solution (20 mL) wasadded, and the mixture was extracted with ethyl acetate (20 mL, twice).The organic layers were combined, were dried, and thereafter, wereconcentrated. The obtained residue was purified by silica gel columnchromatography (aminosilica, methanol:ethyl acetate=0:100 to 5:95) togive the title compound (321 mg) having the following physicalproperties. In addition, the absolute configuration of this compound wasdetermined by X-ray crystallography which used a single crystal of thecomplex of the compound of the present invention and FXIa.

TLC: Rf 0.60 (methanol:ethyl acetate=5:95);

¹H-NMR (CD₃OD): δ 9.31 (s, 1H), 7.91 (dd, 1H), 7.74-7.65 (m, 3H), 6.44(dd, 1H), 6.21 (s, 1H), 6.03 (s, 1H), 5.83 (dd, 1H), 3.39-3.06 (m, 2H),2.62-2.48 (m, 2H);

LC t_(R) 22.5 minutes (column DAICEL CHIRALPAK (registered trademark) IC5 μm 4.6 mm×250 mm, mobile phase: hexane/ethyl acetate=30/70, flow rate:1.0 mL/min); [α]²⁵ _(D)=+44.1° (CH₃OH, c=1.00).

Example 2 (11):(3S)-3-[2-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H-imidazol-5-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinonedihydrochloride

To a solution of the S-configuration compound (43 mg) of Example 2 (9)in dichloromethane (4 mL), trifluoroacetic acid (1 mL) was added, andthe mixture was stirred at room temperature for 70 minutes. The reactionsolution was concentrated under reduced pressure, and the residue wasSubjected to fractionated purification by high performance liquidchromatography (mobile phase B (0.1% trifluoroaceticacid/acetonitrile):mobile phase A (0.1% trifluoroacetic acid aqueoussolution)=5:95 to 95:5). The obtained product was redissolved in ethylacetate, and td the mixture, an excess, amount of 4 M hydrochloricacid/ethyl acetate solution was added, and the mixture was concentratedand was dried to, give the title compound (28 mg) having the followingphysical properties.

LC/MS t_(R) 0.83 minutes; MS (ES+) m/z 508 (M+H) (Condition a);

¹H-NMR (d₆-DMSO): δ 11.7 (brs, 1H), 9.64 (s, 1H), 7.87 (dd, 1H), 7.79(brs, 2H), 7.75 (brs, 1H), 6-38 (dd, 1H), 6.00 (s, 1H), 5.92 (s, 1H),5.69 (d, 1H), 3.23-2.96 (m, 2H), 2.58-2.22 (m, 2H).

Example 2 (12):(3R)-3-[2-(6-amino-2-fluoro-3-pyridinyl)4-fluoro-1H-imidazol-5-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone

The same procedure as in Example 2 (10) was carried out by using theR-configuration compound of Example 2 (9) to give the title compoundhaving the following physical properties.

¹H-NMR (CD₃OD): δ 9.31 (s, 1H), 7.91 (dd, 1H), 7.74-7.65 (m, 3H), 6.44(dd, 1H), 6.21 (s, 1H), 6.03 (s, 1H), 5.83 (dd, 1H), 3.39-3.06 (m, 2H),2.62-2.48 (m, 211);

LC t_(R) 13.6 minutes (column DAICEL CHIRALPAK (registered trademark) IC5 μm 4.6 mm×250 mm, mobile phase: hexane/ethyl acetate=30/70, flow rate:1.0 mL/min);

[α]²³ _(D)=−39.6° (CH₃OH, c=1.00).

Example 2 (13):(3S)-3-[2-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H-imidazol-5-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinonedihydrate

The compound (100 mg) of Example 2 (10) was dissolved in acetonitrile(1.0 mL) and water (0.018 mL) by heating at 75° C., and thereafter, themixture was stirred at 40° C. for 2 hours, and was stirred at roomtemperature for 30 minutes, and the produced precipitate was obtained byfiltration, and was dried under reduced pressure to give the titlecompound (76 mg).

¹H-NMR (CD₃OD): δ 9.31 (s, 1H), 7.91 (dd, 1H), 7.74-7.65 (m, 3H), 6.44(dd, 1H), 6.21 (s, 1H), 6.03 (s, 1H), 5.83 (dd, 1H), 3.39-3.06 (m, 2H),2.62-2.48 (m, 2H);

LC/MS t_(R) 0.82 minutes; MS (ES+) m/z 508 (M+H) (Condition a).

Comparative Example 2 (1): (3S)-3-[2-(6-amino-2-fluoropyridinyl)-1H-imidazol-5-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone

The compound prepared in Example 2 (8) was subjected to the opticalresolution, and the same procedure as in Example 2 (10) was carried outto give the title compound.

Comparative Example 2 (2):2-methyl-2-propanyl[5-(4-chloro-5-{7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinyl}-1H-imidazol-2-yl)-6-fluoro-2-pyridinyl]carbamate

A solution of the compound (1.47 g) prepared in Example 2 (8) in THE (28mL) was cooled to 0° C., and to the solution,1,3-dichloro-5,5-dimethylhydantoin (491 mg) was added, and the mixturewas stirred for 30 minutes. To the reaction mixture, sodium sulfiteaqueous solution was added to degrade the reagent, and to the mixture,water was added, and the mixture was extracted with ethyl acetate. Theobtained organic layer was washed with water, 1 M sodium hydroxideaqueous solution and saturated saline, was dried over anhydrous sodiumsulfate, and thereafter, was concentrated under reduced pressure. Theobtained residue was purified by silica gel column chromatography (ethylacetate:hexane=70:30 to 100:0) to give the title compound (1.10 g).

Comparative Example 2 (3): (3S)-3-[2-(6-amino-2-fluoropyridinyl)-4-chloro-1H-imidazol-5-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone

The compound prepared in Comparative Example 2 (2) was subjected to theoptical resolution, and the same procedure as in Example 2 (10) wascarried out to give the title compound.

Comparative Example 2 (4): Bis(2-methyl-2-propanyl)(5-carbamimidoyl-2-pyridinyl)imidodicarbonate hydrochloride

The same procedure as in Example 2 (2)→Example 2 (4)→Example 2(5)→Example 2 (6) was carried out by using 6-aminonicotinonitrileinstead of the compound prepared in Example 2 (1) to give the titlecompound.

Comparative Example 2 (5):(3S)-3-[2-(6-amino-3-pyridinyl)-4-fluoro-1H-imidazol-5-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone

The same procedure as in Example 2 (8)→Example 2 (9)→Example 2 (10) wascarried out by using the compound prepared in Example 2 (7) and thecompound prepared in Comparative Example 2 (4) to give the titlecompound.

Example 3 (1):(6S)-6-(chloroacetyl)-2-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-7,8-dihydropyrrolo[1,2-a]pyrimidin-4(6H)-one

The same procedure as in Example 2 (7) was carried out by using(6S)-2-[5-chloro-2-(1H-1,2,3,4-tetrazolyl)phenyl]-4-oxo-4H,6H,7H,8H-pyrrolo[1,2-a]pyrimidine carboxylic acid(described in Example 336 of Patent Literature 6) to give the titlecompound having the following physical properties.

LC/MS t_(R) 0.75 minutes; MS (ES+) m/z 391 (M+H) (Condition a).

Example 3 (2): 2-methyl-2-propanyl[5-(5-{2-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-4-oxo-4,6,7,8-tetrahydropyrrolo[1,2-a]pyrimidin-6-yl}-1H-imidazol-2-yl)-6-fluoro-2-pyridinyl]carbamate

The same Procedure as in Example 2 (8) was carried out by using thecompound prepared in Example 2 (6) and the compound of Example 3 (1) togive the title compound having the following physical properties.

LC/MS t_(R) 0.79 minutes; MS (ES+) m/z 591 (M+H) (Condition a).

Example 3 (3): 2-methyl-2-propanyl[5-(5-{(6S)-2-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-4-oxo-4,6,7,8-tetrahydropyrrolo[1,2-a]pyrimidin-6-yl}-4-fluoro-1H-imidazol-2-yl)-6-fluoro-2-pyridinyl]carbamateand 2-methyl-2-propanyl[5-(5-{(6R)-2-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-4-oxo-4,6,7,8-tetrahydropyrrolo[1,2-a]pyrimidin-6-yl}-4-fluoro-1H-imidazol-2-yl)-6-fluoro-2-pyridinyl]carbamate

The same procedure as in Example 2 (9) was carried out by using thecompound prepared in Example 3 (2) to give the title compound having thefollowing physical properties. Meanwhile, when the optical resolution(DAICEL, CHIRALFLASH (registered trademark) IC column, (particle size:20 μm; column length: 100×30 mm I.D.), flow rate; 24 mL/min; columntemperature room temperature; mobile phase: acetonitrile; detector: UVYamazen UV-254W UV-Detector) was conducted, the retention times of thetitle compounds were 13.7 minutes (the S-configuration compound ofExample 3 (3)) and 8.1 minutes (the R-configuration compound of Example3 (3)), respectively.

The physical properties of each of the title compounds when beinganalyzed under liquid chromatographic conditions in parentheses beloware shown hereinbelow.

The S-configuration compound of Example 3 (3)LC t_(R) 4.15 minutes (column DAICEL CHIRALPAK (registered trademark) IC3 μm 4.6 mm×250 mm, mobile phase: methanol, flow rate: 1.0 mL/min).The R-configuration compound of Example 3 (3):LC t_(R) 3.75 minutes (column DAICEL CHIRALPAK (registered trademark) IC3 μm 4.6 mm×250 mm, mobile phase: methanol, flow rate: 1.0 mL/min).

Example 3 (4):(6S)-6-[2-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H-imidazol-5-yl]-2-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-7,8-dihydropyrrolo[1,2-a]pyrimidin-4(6H)-one

The same procedure as in Example 2 (10) was carried out by using theS-configuration compound of Example 3 (3) to give the title compoundhaving the following physical properties.

TLC: Rf 0.65 (methanol:ethyl acetate=5:95);

¹H-NMR (CD₃OD) δ 9.40 (s, 1H), 7.95-7.86 (m, 2H), 7.76 (dd, 1H), 7.68(d, 1H), 6.44 (dd, 1H), 6.41 (s, 1H), 5.78 (dd, 1H), 3.12 (m, 1H), 2.90(m, 1H), 2.62 (m, 1H) 2.41 (m, 1H);

LC t_(R) 4.23 minutes (column DAICEL CHIRALPAK (registered trademark) IC3. μm 4.6 mm×250 mm, mobile phase: methanol, flow rate: 1.0 ml/min);

[α]²⁵ _(D)=+74.6° (CH₃OH, c=1.00).

Example 3 (5): (6R)-6-[2-(6-amino2-fluoro-3-pyridinyl)-4-fluoro-1H-imidazol-5-yl]-2-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-7,8-dihydropyrrolo[1,2-a]pyrimidin-4(6H)one dihydrochloride

The same procedure as in Example 2 (11) was carried out by using theR-configuration compound of Example 3 (3) to give the title compoundhaving the following Physical Properties.

¹H-NMR (CD₃OD): δ 9.44 (s, 1H), 7.95-7.85 (m, 2H), 7.78 (dd, 1H), 7.71(d, 1H), 6.50 (dd, 1H), 6.42 (s, 1H), 5.80 (dd, 1H), 3.13 (m, 1H), 2.98(m, 1H), 2.72 (m, 1H) 2.43 (m, 1H);

LC t_(R) 4.63 minutes (column DAICEL CHIRALPAK (registered trademark) IC3 μm 4.6 mm×250 mm, mobile phase: methanol, flow rate: 1.0 mL/min).

Comparative Example 3 (1):methyl[4-(4-chloro-5-{(6S)-2-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-4-oxo-4,6,7,8-tetrahydropyrrolo[1,2-a]pyrimidin-6-yl}-1H-imidazolyl)phenyl]carbamate

A compound obtained by carrying out the same procedure as in Example 2(8) to Comparative Example 2 (2) by using the compound synthesized inExample 3 (1) and the compound described in Example 237 of PatentLiterature 6 was subjected to the optical resolution to give the titlecompound.

Example 4 (1): ethyl(3S)-7-(2-azido-5-chlorophenyl)-5-oxo-1,2,3,5-tetrahydro-3-indolizinecarboxylate

To a solution (15 mL) of ethyl(3S)-7-(2-amino-5-chlorophenyl)-5-oxo-1,2,3,5-tetrahydroindolizine-3-carboxylate(described in Example 7 of Patent Literature 6) (2.0 g) in acetonitrile,trimethylsilyl azide (1.39 g) and amyl nitrite (1.41 g) were added withcooling (0° C.) The mixture was stirred at room temperature for 1 hour,and thereafter, was concentrated. The residue was purified by columnchromatography (ethyl acetate:hexane=10:90 to 100:0) to give the titlecompound (1.89 g) having the following physical property.

TLC: Rf 0.75 (methanol:ethyl acetate=5:95).

Example 4 (2): ethyl(3S)-7-[2-(4-carbamoyl-1H-1,2,3-triazol-1-yl)-5-chlorophenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinecarboxylate

To a solution (45 mL) of the compound (15.0 g) prepared in Example 4 (1)in N,N-dimethylformamide, propiolamido (3.18 g),(R)-3,4-dihydroxy-5-((S)-2,2-dihydroxyethyl)furan-2(5H)-one (1.47 g) andcopper (II) sulfate (0.33 g) were added. The mixture was stirred at 50°C. for 10 minutes, and thereafter, to the mixture, water was added. Theprecipitate was obtained by filtration, was washed with water, andthereafter, was dried to give the title compound (17.5 g) having thefollowing physical properties.

LC/MS t_(R) 0.69 minutes; MS (ES⁺) m/z 428 (M+H) (Condition b).

Example 4 (3):(3S)-7-[2-(4-carbamoyl-1H-1,2,3-triazol-1-yl)-5-chlorophenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinecarboxylicacid

To a solution (10 mL) of the compound (100 mg) prepared in Example 4 (2)in 1,4-dioxane, 5 M hydrochloric acid (5 mL) was added. The mixture wasstirred at 60° C. for 5 hours, and thereafter, to the mixture, 5 Msodium hydroxide aqueous solution (5 mL) was added at room temperatureand the mixture was extracted with ethyl acetate. The organic layer wasdried, and thereafter, was concentrated to give the title compound (61.7mg) having the following physical properties.

LC/MS t_(R) 0.60 minutes: MS (ES⁺) m/z 400 (M+H) (Condition b).

Example 4 (4):2-[4-({[(2-methyl-2-propanyl)oxy]carbonyl}amino)phenyl]-2-oxoethyl(3S)-7-[2-(4-carbamoyl-1H-1,2,3-triazol-1-yl)-5-chlorophenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinecarboxylate

To a solution (61 mL) of the compound (6.10 g) prepared in Example 4 (3)in N,N-dimethylformamide, test-butylN-[4-(2-bromoacetyl)phenyl]carbamate (7.19 g) andN,N-diisopropylethylamine (5.3 mL) were added. The mixture was stirredat room temperature for 3 days, and thereafter, to the mixture, waterand ethyl acetate were added. The precipitate was collected byfiltration, and was washed with water, and thereafter, was dried to givethe title compound (3.93 g) having the following physical properties.

LC/MS t_(R) 0.90 minutes: MS (ES⁺) m/z 633 (M+H) (Condition b).

Example 4 (5): 2-methyl-2-propanyl[4-(2-{(3S)-7-[2-(4-carbamoyl-1H-1,2,3-triazol-1-yl)-5-chlorophenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinyl}-1H-imidazol-5-yl)phenyl]carbamate

The compound (3.93 g) prepared in Example 4 (4) was dissolved in toluene(79 mL) and glacial acetic acid (3.9 mL), and to the mixture, ammoniumacetate (9.57 g) was added. The mixture was stirred under reflux byheating for 4 hours, and thereafter, to the mixture, water and ethylacetate were added. The organic layer was washed with water, andthereafter, was dried to give the title compound (3.98 g) having thefollowing physical properties.

LC/MS t_(R) 0.73 minutes: MS (ES⁺) m/z 613 ad-Flo (Condition b).

Example 4 (6); 2-methyl-2-propanyl[4-(2-{(3S)-7-[5-chloro-2-(4-cyano-1H-1,2,3-triazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinyl}-1H-imidazol-5-yl)phenyl]carbamate

To a solution (76 mL) of the compound (3.81 g) prepared in Example 4 (5)in pyridine, trifluoroacetic anhydride (4.3 mL) was added with cooling(0° C.) The mixture was stirred at 0° C. for 2 hours, and thereafter, tothe mixture, water was added, and the mixture was extracted with ethylacetate. The organic layer was washed with saturated saline, andthereafter, was dried and was concentrated, and the obtained residue wasdissolved in tetrahydrofuran, and to the mixture, aqueous ammonia wasadded, and the mixture was stirred for 30 minutes. The mixture wasconcentrated, and the residue was purified by column chromatography(diol silica gel, ethyl acetate:hexane=50:50 to 80:20) (aminosilica gel,ethyl acetate:hexane=50:50 to 80:20) to give the title compound (2.39 g)having the following physical properties.

LC/MS t_(R) 0.83 minutes: MS (ES+) m/z 595 (M+H) (Condition b).

Example 4 (7): 2-methyl-2-propanyl[4-(2-{(3S)-7-[5-chloro-2-(4-cyano-1H-1,2,3-triazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinyl}-1-{[2-(trimethylsilyl)ethoxy]methyl}-1H-imidazol-4-yl)phenyl]carbamate

To a solution (20 mL) of the compound (2.00 g) prepared in Example 4 (6)in N,N-dimethylformamide, N,N-diisopropylethylamine (0.87 mL) and2-(trimethylsilyl)ethoxymethyl chloride (0.66 mL) were added withcooling (0° C.) The mixture was stirred at room temperature for 8 hours,and thereafter, to the mixture, saturated ammonium chloride aqueoussolution was added, and the mixture was extracted with ethyl acetate.The organic layer was washed with saturated saline, and thereafter, wasdried and was concentrated. The residue was purified by columnchromatography (diol silica gel, ethyl acetate:hexane=30:70 to 50:50) togive the title compound (2.27 g) having the following physicalproperties.

LC/MS t_(R) 1.17 minutes: MS (ES⁺) m/z 725 (M+H) (Condition b).

Example 4 (8): 2-methyl-2-propanyl[4-(2-{(3S)-7-[5-chloro-2-(4-cyano-1H-1,2,3-triazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinyl}-5-fluoro-1-{[2-(trimethylsilyl)ethoxy]methyl}-1H-imidazol-4-yl)phenyl]carbamate

The compound (560 mg) prepared in Example 4 (7) was dissolved intetrahydrofuran (5.6 mL) and acetonitrile (2.8 mL), and to the mixture,sodium carbonate (205 mg) and1-chloromethyl-4-fluoro-1,4-diazoniabicyclo[2.2.2]octanebis(tetrafluoroborate) (219 mg) were added at −10° C., and the mixturewas stirred for 6 hours. The reaction mixture was diluted with ethylacetate, and to the mixture, water was added, and the mixture wassubjected to liquid separation, and the aqueous layer was extracted withethyl acetate. The organic layers were combined, were washed withsaturated saline, were dried, and thereafter, were concentrated. Theresidue was purified by column chromatography (ethylacetate:hexane=30:70 to 50:50) to give the title compound (277 mg)having the following physical properties.

LC/MS t_(R) 1.30 minutes: MS (ES⁺) m/z 743 (M+H) (Condition a).

Example 4 (9) r 2-methyl-2-propanyl[4-(2-{(3S)-7-[5-chloro-2-(4-cyano-1H-1,2,3-triazol-1-yl)phenyl]-5-oxo-1,2,3,5-tetrahydro-3-indolizinyl}-4-fluoro-1H-imidazol-5-yl)phenyl]carbamate

To a solution (4.3 mL) of the compound (427 mg) prepared in Example 4(8) in 1,4-dioxane, 5 M hydrochloric acid aqueous solution (0.43 mL) wasadded. The mixture was stirred at room temperature for 30 minutes, andthereafter, to the mixture, saturated sodium bicarbonate aqueoussolution was added, and the mixture was extracted with ethyl acetate.The organic layer was washed with saturated saline, and thereafter, wasdried and was concentrated. The residue was purified by columnchromatography (diol silica gel, ethyl acetate:hexane=35:65 to 50:50) togive the title compound (320 mg) having the following physicalproperties.

LC/MS t_(R) 1.11 minutes: MS (ES⁺) m/z 613 (M+H) (Condition a).

Example 4 (10):1-(2-{(3S)-3-[5-(4-aminophenyl)-4-fluoro-1H-imidazol-2-yl]-5-oxo-1,2,3,5-tetrahydroindolizinyl}-4-chlorophenyl)-1H-1,2,3-triazole-4-carbonitrile

To a solution (6.4 mL) of the compound (320 mg) prepared in Example 4(9) in dichloromethane, trifluoroacetic acid (0.96 mL) was added. Themixture was stirred at room temperature for 45 minutes, and thereafter,to the mixture, toluene was added and the mixture was concentrated. Theresidue was purified by column chromatography (aminosilica gel, ethylacetate:hexane=65:35 to 100:0) to give the title compound (232 mg)having the following physical properties.

LC/MS t_(R) 0.79 minutes: MS (ES⁺) m/z 513 (M+H) (Condition a);

¹H NMR (300 MHz, methanol-d₄); δ 8.88 (s, 1H), 7.73-7.65 (m, 3H), 7.30(d, 2H), 6.75 (d, 2H), 6.11 (s, 1H), 6.08 (s, 1H), 5.70 (d, 1H), 3.42(m, 1H), 3.10 (m, 1H), 2.61 (m, 1H), 2.39 (m, 1H).

Biological Experimental Examples will be described hereinbelow, and theeffects of the compound of the present invention were confirmed based onthe experimental methods.

Meanwhile, as Comparative Compounds, the following compounds describedin Patent Literature 6 were used, With regard to the BiologicalExperimental Examples hereinbelow, the Comparative Compounds wereevaluated in the same manner as the compound of the present invention.

(3B)-3-[5-(6-amino-2-fluoro-3-pyridinyl)-1H-imidazol-2-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone(referred to as Comparative Example 1 (1)):

(3S)-3-[5-(6-amino-2-fluoro-3-pyridinyl)-4-chloro-1H-imidazol-2-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone (referred to as Comparative Example 1 (2)):

(3S)-3-[5-(6-amino-3-pyridinyl)-4-fluoro-1H-imidazol-2-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone(referred to as Comparative Example 1 (3)):

(3S)-3-[2-(6-amino-2-fluoro-3-pyridinyl)-1H-imidazol-5-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone(Comparative Example 2 (1));

(3S)-3-[2-(6-amino-2-fluoro-3-pyridinyl)-4-chloro-1H-imidazol-5-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone(Comparative Example 2 (3))

(3S)-3-[2-(6-amino-3-pyridinyl)-4-fluoro-1H-imidazol-5-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone(Comparative Example 2 (5)):

methyl[4-(4-chloro-5-{(6S)-2-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-4-oxo-4,6,7,8-tetrahydropyrrolo[1,2-a]pyrimidin-6-yl}-1H-imidazolyl)phenyl]carbamate (Comparative Example 3 (1)):

(6S)-6-[5-(6-amino-2-fluoro-3-pyridinyl)-4-chloro-1H-imidazol-2-yl]-2-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-7,8-dihydropyrrolo[1,2-a]pyrimidin-4(6H)-one (Comparative Example 3 (2)):

1-(2-{(3S)-3-[5-(6-amino-3-pyridinyl)-4-chloro-1H-imidazol-2-yl]-5-oxo-1,2,3,5-tetrahydro-7-indolizinyl}-4-chlorophenyl)-1H-1,2,3-triazole-4-carbonitrile(referred to as Comparative Example 4):

Biological Example 1 (1) In Vitro Assay

Inhibitory activities of the compound of the present invention on humanblood coagulation factor XIa, factor VIIa, factor IXa, factor Xa, factorXIIa, plasma kallikrein and thrombin were evaluated. A chromogenicsubstrate solution was added to each of enzyme solutions, the absorbanceat 405 nm was measured continuously at 37° C. for 5 minutes at intervalsof 15 seconds, and the decomposition rate of each of substrates(mOD/min) was calculated. The half maximal (50%) inhibitoryconcentration (IC50) of the compound of the present invention on each ofthe enzymes was calculated by linear regression by using least-squaresmethod from the concentration of the compound of the present inventionwhich was converted in terms of natural logarithm and the rate of enzymeinhibition calculated according to the following equation.

The rate of enzyme inhibition (%) of the compound of the presentinvention was calculated by using the following equation:

Rate of enzyme inhibition(%)=100×{(Cont(e)−BL(e)−(Comp(e)−BL(e))/(Cont(e)−BL(e))}

Cont (e) Decomposition rate of substrate (mOD/min) when enzyme solutionand substrate solution were added to physiological saline containing 5%dimethyl sulfoxide

BL (e) Decomposition rate of substrate (mOD/min) when buffer solutionwhich did not contain enzyme and substrate solution were added tophysiological saline containing 5% dimethyl sulfoxide

Comp (e): Decomposition rate of substrate (mOD/min) when enzyme solutionand substrate solution were added to physiological saline containing 5%dimethyl sulfoxide and the compound of the present invention

(1-1) Measurement of Inhibitory Activity on Human Blood CoagulationFactor XIa:

The inhibitory activity on human blood coagulation factor XIa(Haematologic Technologies Inc.) was measured by using the enzymesolution adjusted to 0.1 U/mL by a buffer solution containing 300 mM ofNaCl, 10 mM of KCl, 2 mg/mL of PEG 6000 and 100 mM of HEPES-NaOH (pH7.4) as well as S-2366 (pyroglu-Pro-Arg-pNA, CHROMOGENIX) adjusted to 1mM by distilled water.

(1-2) Measurement of Inhibitory Activity on Human Plasma Kallikrein:

The inhibitory activity on human plasma kallikrein (Enzyme ResearchLaboratories Ltd.) was measured by using the enzyme solution adjusted to20 mU/mL by a buffer solution containing 400 mM of NaCl, 10 mg/mL of PEG6000 and 200 mM of phosphate buffer solution (pH 7.4) as well as S-2302(H-D-Pro-Phe-Arg-pNA, CHROMOGENIX) adjusted to 500 μM by distilledwater.

(1-3) Measurement of Inhibitory Activities on Human Blood CoagulationFactor Xa and Human Thrombin

The inhibitory activity on human blood coagulation factor Xa (SekisuiDiagnostics LLC.) and the inhibitory activity on human thrombin (Sigma)were measured by using each of the enzyme solutions adjusted to 0.5 U/mLor 0.25 U/mL, respectively, by a buffer solution containing 300 mM ofNaCl, 4 mg/mL of PEG 6000 and 100 mM of Tris-HCl (pH 7.4) as well asS-2222 [Bz-Ile-Glu(γ-OR)-Gly-Arg-pNA.HCl, R═H (50%) and R═CH3 (50%),CHROMOGENIX] or S-2366 each adjusted to 1 mM by distilled water.

(1-4) Measurement of Inhibitory Activity on Human Blood CoagulationFactor XIIa:

The inhibitory activity on human blood coagulation factor XIIa (EnzymeResearch Laboratories Ltd.) was measured by using the enzyme solutionadjusted to 0.78 U/mL by a buffer solution containing 300 mM of NaCl and100 mM of Tris-HCl (pH 7.4) as well as S-2302 adjusted to 1 mM bydistilled water.

(1-5) Inhibitory Activity on Human Blood Coagulation Factor IXa:

The inhibitory activity on human blood coagulation factor IXa (SekisuiDiagnostics LLC.) was measured by using the enzyme solution adjusted to30 U/mL by a buffer solution containing 200 mM of NaCl, 10 mM of CaCl₂,60% of ethylene glycol and 100 mM of Tris-HCl (pH 7.4) as well asSpectrozume FIXa (H-D-Leu-Ph′Gly-Arg-pNA.2AcOH, Sekisui DiagnosticsLLC.) adjusted to 10 mM by distilled water.

(1-6) Inhibitory Activity on Human Blood Coagulation Factor VIIa:

The inhibitory activity on human blood coagulation factor Vila (SekisuiDiagnostics LLC.) was measured by using the enzyme solution adjusted to200 U/mL by a buffer solution containing 300 mM of NaCl, 10 mM of CaCl₂,10 mg/mL of PEG 6000, 100 mM of HEPES-NaOH (pH 7.4) and recombinanthuman tissue factor (prepared according to the method of Alireza R.Rezaie et al., (Protein expression and purification, 1992, Vol, 3, No.6, pages 453-460)) as well as 3-2288 (H-D-Ile-Pro-Arg-pNA, CHROMOGENIX)adjusted to 10 mM by distilled water.

(2) Measurement of Activated Partial Thromboplastin Time and ProthrombinTime

Activated partial thromboplastin time (APTT) and prothrombin time (PT)were measured by using a fully automatic device for measuring bloodcoagulation (CA-1500, Sysmex Corporation), On APTT or PT measurement,standard human plasma for the blood coagulation tests (SiemensHealthcare Diagnostics GmbH) was mixed with a diluted solution of thecompound of the present invention, and thereafter, APTT reagent (SiemensHealthcare Diagnostics GmbH) and 0.02 M of calcium chloride or PTreagent (Siemens Healthcare Diagnostics GmbH) were automatically addedto the mixture in order to initiate clot formation. The anticoagulationactivity (APTT×2 or PT×2) of the compound of the present invention wasexpressed as a concentration required for doubling the coagulation timein the vehicle (1% DMSO) group, APTT×2 or PT×2 was determined byplotting the concentration of the compound of the present inventionagainst a twofold increase in the coagulation time.

TABLE 1 FXIa inhibitory activity IC50 (μM) APTT × 2 (μM) Example 1 (6)0.0017 0.80 Example 2 (10) 0.0017 0.49 Example 3 (4) 0.0019 0.47 Example4 (10) 0.0054 1.8 Comparative Example 1 (1) 0.0038 1.2 ComparativeExample 1 (2) 0.0048 1.8 Comparative Example 1 (3) 0.0014 0.55Comparative Example 2 (1) 0.019 4.0 Comparative Example 2 (3) 0.0044 2.1Comparative Example 2 (5) 0.0016 0.21 Comparative Example 3 (1) 0.00160.64 Comparative Example 3 (2) 0.011 3.7 Comparative Example 4 0.00272.0

As a result of the above-described tests, it was confirmed that thecompound of the present invention has a potent FXIa inhibitory activityand an anticoagulation activity. Meanwhile, inhibitory activities of thecompound of the present invention on human blood coagulation factor Xa,factor XIIa, factor IXa, factor VIIa and human thrombin weresufficiently low.

Biological Experimental Example 2: Pharmacokinetic (PK) Tests in Rats

The compound of the present invention was administered to fasted maleCrj:CD(SD) rats by intravenous injection as a single intravenous dose of0.1 mg/kg (vehicle: 20% HP-β-CD solution) and by forced oral dosage as adose of 1 mg/kg per os (vehicle: 0.5% methylcellulose solution). Bloodsamples were collected from cervical vein into heparinized syringes at0.08, 0.25, 0.5, 1, 3 or 7 hours after administration by intravenousinjection or 0.08, 0.25, 0.5, 1, 2, 4, 6, 8 or 24 hours after oraladministration. Plasma was obtained by centrifugation, and plasma wasstored at −20° C. until measurement of plasma concentration.

In order to measure the plasma concentration of the compound of thepresent invention, the plasma sample was subjected to deproteinizationby using acetonitrile, was filtrated by using a filter, and thereafter,was diluted with purified water, and then was analyzed by LC/MS/MS. Acolumn for analysis (Shim-pack XR-ODSII, 2.0 mm×75 mm, 2.2 μm) andmobile phases (0.1% formic acid in water and 0.1% formic acid inacetonitrile, flow rate: 0.5 mL/min) were used. The system was used bydetection of cations in the Multiple Reaction Monitoring (MRM) mode.

The area under the blood concentration versus time curve (AUC) and thebioavailability (BA) of the compound of the present invention werecalculated. In addition, as indices of the maintaining time of theanticoagulation activity in the case of oral administration, AUC/APTT×2,which is obtained by dividing AUC by APTT×2, and C8h/APTT×2, which isobtained by dividing C8h (the plasma concentration at 8 hours afteradministration) by APTT×2, were calculated.

TABLE 2 Plasma AUC concentration AUC/ C8h/ (μM · h) C8h (μM) APTT × 2APTT × 2 Example 1 (6) 33 0.88 41 1.1 Example 2 (10) 15 1.0 30 2.1Example 3 (4) 28 1.6 61 3.4 Example 4 (10) 45 2.5 25 1.4 Comparative 4.70.17 4.0 0.15 Example 1 (1) Comparative 0.69 0.026 0.39 0.014 Example 1(2) Comparative 1.7 0.081 3.0 0.15 Example 1 (3) Comparative 0.056 BLQ*0.014 — Example 2 (1) Comparative 23 1.1 11 0.52 Example 2 (3)Comparative 1.6 0.073 7.5 0.34 Example 2 (5) Comparative 4.2 0.18 6.50.29 Example 3 (1) Comparative 1.4 0.027 0.39 0.0073 Example 3 (2)Comparative 8.4 0.35 4.2 0.18 Example 4 *BLQ: Below the Limit ofQuantitation (0.0024 μM)

In, addition, the period of time when the compound concentration inplasma of the compound of the present invention exceeded APTT×2 (theAPTT×2 maintaining time) was calculated from the change in the compoundconcentration in plasma in the case when the compound of the presentinvention was orally administered at a dose of 1 mg/kg. The longer theAPTT×2 maintaining time is, the longer the period of time is when theanticoagulation activity is maintained after oral administration.Accordingly, it is suggested that a compound which exhibits a longAPTT×2 maintaining time may be an excellent agent for preventing and/ortreating thromboembolic disease which requires a small number ofadministrations

TABLE 3 APTT × 2 maintaining time (h) Example 1 (6) >8  Example 2(10) >8  Example 3 (4) >8  Example 4 (10) >8  Comparative Example 1 (1)  0* Comparative Example 1 (2)   0* Comparative Example 1 (3) <1 Comparative Example 2 (1)   0* Comparative Example 2 (3) <2  ComparativeExample 2 (5) <2  Comparative Example 3 (1) <2  Comparative Example 3(2)   0* Comparative Example 4   0* *Plasma concentration at any timepoint of blood collection did not exceed APTT × 2 (μM).

In addition, the relationships of the changes in the compoundconcentrations in plasma of the compounds described in Example 2 (10),Example 4 (10) and Comparative Example 2 (3) with APTT×2 are shown inFIG. 1 , FIG. 2 and FIG. 3 .

As a result of the above-described tests, it was confirmed that thecompound of the present invention exhibited good kinetics in blood. Inaddition, when the compound of the present invention was orallyadministered at a dose of 1 mg/kg, the compound of the present inventionshowed a C8h/APTT×2 of equal to or more than 1. Further, while thecompound of the present invention maintained the plasma concentrationequal to or higher than APTT×2 for 8 hours or longer, the APTT×2maintaining time of each of Comparative Compounds was shorter than 2hours.

From the results described above, it was confirmed that the compound ofthe present invention exhibited both good kinetics in blood and a potentanticoagulation activity and is capable of exhibiting theanticoagulation activity for a long period of time after oraladministration.

Biological Experimental Example 3: Drug Interaction

(1) CYP Inhibitory Activity

Competitive Inhibitory Activity

Midazolam and the compound of the present invention were added to asuspension of human liver microsomes and the mixture was shaken at 37°C. for 3 minutes, and thereafter, the concentration of1′-hydroxymidazolam in the sample was analyzed by LC/MS/MS.

Time-Dependent Inhibitory (TDI) Activity

The compound of the present invention was added to a suspension of humanliver microsomes and the mixture was shaken at 37° C. for 30 minutes,and thereafter, midazolam was added to the mixture, and the mixture wasfurther shaken for 3 minutes. The concentration of 1′-hydroxymidazolamin the sample after shaking was analyzed by LC/MS/MS.

With regard to both the competitive inhibitory activity and the TDIactivity, a column for analysis (Shim-pack XR-ODSII, 2.0 mm×75 mm, 2.2μm) and mobile phases (0.1% formic acid in water and 0.1% formic acid inacetonitrile, flow rate: 0.5 mL/min) were used. The system was used bydetection of cations in the Multiple Reaction Monitoring (MRM) mode. Asan index of the CYP inhibitory activity of the competitive inhibitionand TDI, the IC50 value was calculated according to the followingequations by using a plurality of the concentrations of the compound ofthe present invention in the sample selected from 1, 3, 10, 15, 30 and50 μmol/l. However, when the inhibition rate was equal to or higher than50% in the case where each of the compounds was evaluated at the minimumconcentration of 1 or 5 μmol/L, the IC50 value was evaluated as <1 or <5μmol/L, and when the inhibition rate was equal to or lower than 50% inthe case where each of the compounds was evaluated at the maximumconcentration of 10, 30 or 50 μmol/L, the IC50 value was evaluatedas >10, >30 or >50 μmol/L, respectively.

IC50=(50−a)/b

a=(B×C−D×A)/(B−D)

b=(A−C)/(B−D)

Inhibition rate (%)=100−(the concentration of 1′−hydroxymidazolam at thetime when the compound of the present invention was added)/(theconcentration of 1′−hydroxymidazolam at the time when the compound ofthe present invention was not added)×100

The lowest inhibition rate which exceeded the inhibition rate 50% wastaken to be A (%), and the concentration of the compound of the presentinvention at that time was taken to be B (μmol/L). On the other hand,the highest inhibition rate which was lower than the inhibition rate 50%was taken to be C (%), and the concentration of the compound of thepresent invention at that time was taken to be D (μmol/L).

In addition, as an index of the discrepancy between the concentration atwhich the anticoagulation activity can be exhibited and the CYPinhibitory activity, the CYP IC50 value (TDI)/APTT×2 was calculated.

TABLE 4 CYP CYP IC50 CYP IC50 (TDI)/ IC50 (μM) (TDI) (μM) APTT × 2Example 1 (6) 28 3.8 4.8 Example 2 (10) >50 31 64 Example 3 (4) 18 14 31Example 4 (10) 9.1 5.0 2.8

As a result of the above-described tests, it was confirmed that the CYPinhibitory activity of the compound of the present invention was low. Inaddition, it was confirmed that there was a discrepancy between theanticoagulation activity and the CYP inhibitory activity.

From the above-described results, it was confirmed that the compound ofthe present invention is a compound which is a potent FXIa inhibitor, isexcellent in oral absorbability and kinetics in blood, exhibits a potentanticoagulation activity for a long period of time after oraladministration and exhibits a discrepancy between the anticoagulationactivity and the CYP inhibitory activity.

(2) Evaluation of CYP3A4 Inhibition by Using Hepatic Cells Suspended inSerum

The compound of the present invention was added to a suspension of humanhepatic cells suspended in human serum and the mixture was shaken at 37°C. for 10 minutes. Thereafter, midazolam was added to the mixture andthe mixture was further shaken for 90 minutes. The concentration of1′-hydroxymidazolam in the sample after shaking was analyzed byLC/MS/MS. A column for analysis (Shim-pack XR-ODSII, 2.0 mm×75 mm, 2.2μm) and mobile phases (0.1% formic acid in water and 0.1% formic acid inacetonitrile, flow rate: 0.5 mL/min) were used. The system was used bydetection of cations in the Multiple Reaction Monitoring (MRM) mode. Theconcentration of the compound of the present invention in the sample wasmade to be 10 μmol/L, 30 μmol/L or 100 μmol/L.

Biological Experimental Example 4: Toxicity

(1) hERG Inhibitory Action

The hERG inhibitory activity of the compound of the present inventionwas measured by the following procedure.

The hERG channel current (IKr) induced by stimulation pulses wasmeasured by using CHO-K1 cells transfected with hERG gene and using afully automatic patch clamp system according to theamphotericin-perforated patch clamp technique. The stimulation pulseswere set as follows: holding potential: −80 mV, depolarizing potential:+40 mV (2 seconds) and repolarizing potential: −50 mV (2 seconds), Themaximum tail current induced after applying the repolarizing potentialwas measured. Stimulation pulses were applied twice, that is, beforeadding the compound of the present invention and 5 minutes after addingthe compound of the present invention. The rate of change of the maximumtail current to the current before adding the compound of the presentinvention was calculated. The compound of the present invention was usedas a solution in dimethyl sulfoxide (DMSO) and was added at theconcentration of 1% to the extracellular fluid. The inhibition rate (%)of the hERG channel was calculated by correcting the rate of change inthe maximum tail current before and after the addition of the compoundof the present invention by the rate of change in a vehicle-treatedgroup.

Inhibition rate (%)=[1−(the rate of change in current before and afterthe addition of the compound of the present invention)/(the rate ofchange in current before and after the addition of the vehicle)]×100

As a result, when the compound of the present invention was added tocells at the concentration of 10 the hERG inhibition rate was below 51%.From the above-described result, it could be confirmed that the compoundof the present invention has a low hERG inhibitory activity, andtherefore, is a compound excellent in safety.

(2) Evaluation of Steatosis

The steatosis-inducing effect of the compound of the present inventionwas measured by the following procedure.

To a medium of a human immortalized hepatic cell line Fa2N-4, 1% of asolution of the compound of the present invention in DMSO at aconcentration of 6.25, 12.5, 25, 50 or 100 μM was added, and the cellswere exposed for 72 hours, Thereafter, Nile Red was added to the medium,and the fluorescence intensity of the cells was measured at anexcitation wavelength of 485 nm and an fluorescent wavelength of 570 nm.When the measured fluorescence value was equal to or more than 160% ofthe value obtained by a vehicle treatment, it was determined that thecompound exhibits a steatosis-inducing effect.

As a result, when the concentration of the compound of the presentinvention in the medium was 25 μM, the measured fluorescence value wasless than 160% of the measured fluorescence value in the case of thevehicle treatment, From the above-described result, it could beconfirmed that the compound of the present invention exhibits a lowsteatosis-inducing effect and is a compound excellent in safety.

PREPARATION EXAMPLES Preparation Example 1

The following ingredients are mixed in a conventional manner andcompressed to give 10,000 tablets each containing 10 mg of the activeingredient.

(3S)-3-[5-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H- 100 gimidazol-2-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone Carboxymethyl cellulose calcium  20 gMagnesium stearate  10 g Microcrystalline cellulose 870 g

Preparation Example 2

The following ingredients are mixed in a conventional manner,Thereafter, the mixture is filtered through a dust filter, and 5 mlaliquots are charged into ampules. The ampules are heat sterilized by anautoclave to give 10,000 ampules each containing 20 mg of the activeingredient.

(3S)-3-[5-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H- 200 gimidazol-2-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone Mannitol 20 g Distilled water 50 L

INDUSTRIAL APPLICABILITY

The compound of the present invention has a potent. FXIa inhibitoryactivity, and therefore, is useful for the prevention and/or treatmentof thromboembolic disease.

1-14. (canceled)
 15. A compound represented by general formula (I):

represents:

represents:

and X represents CH or N]; a salt thereof, a solvate thereof, an N-oxidethereof or a prodrug thereof.
 16. A pharmaceutical compositioncomprising the compound according to claim 15, a salt thereof, a solvatethereof, an N-oxide thereof or a prodrug thereof as an activeingredient.
 17. A method of inhibiting FXIa activity comprisingadministering an effective dose of the compound according to claim 15, asalt thereof, a solvate thereof, an N-oxide thereof or a prodrug thereofto a patient in need thereof.
 18. An agent for preventing and/ortreating thromboembolic disease, comprising the compound according toclaim 15, a salt thereof, a solvate thereof, an N-oxide thereof or aprodrug thereof as an active ingredient.
 19. The agent according toclaim 18, wherein the thromboembolic disease is arterial cardiovascularthromboembolic disorder, venous cardiovascular thromboembolic disorder,arterial cerebrovascular thromboembolic disorder, venous cerebrovascularthromboembolic disorder or thromboembolic disorder in the heart chamberor in the peripheral circulation.
 20. The agent according to claim 18,wherein the thromboembolic disease is coronary artery disease, unstableangina, acute coronary syndrome, atrial fibrillation, myocardialinfarction, ischemic sudden death, transient ischemic attack, cerebralstroke, peripheral arterial disease, atherosclerosis, peripheralocclusive arterial disease, venous thrombosis, venous thromboembolism,deep venous thrombosis, thrombophlebitis, arterial embolism, coronaryartery thrombosis, cerebral arterial thrombosis, cerebral embolism,kidney embolism, portal vein thrombosis, pulmonary embolism, pulmonaryinfarction, liver embolism, hepatic veno-occlusive disease/sinusoidalobstruction syndrome, thrombotic microangiopathy, disseminatedintravascular coagulation, sepsis, acute respiratory distress syndrome,acute lung injury, antiphospholipid antibody syndrome, thrombosisresulting from coronary artery bypass graft surgery or thrombosisinduced by treatment in which blood is exposed to an artificial surfacewhich promotes thrombus formation.
 21. The agent according to claim 18,wherein the thromboembolic disease is venous thromboembolism, ischemicstroke, thromboembolic disease induced by treatment in which blood isexposed to an artificial surface which promotes thrombus formation,acute coronary syndrome, coronary artery disease or peripheral arterialdisease.
 22. A method for preventing and/or treating thromboembolicdisease, comprising administering an effective dose of the compoundaccording to claim 15, a salt thereof, a solvate thereof, an N-oxidethereof or a prodrug thereof to a patient in need of prevention and/ortreatment of the thromboembolic disease.
 23. The method according toclaim 22, wherein the thromboembolic disease is arterial cardiovascularthromboembolic disorder, venous cardiovascular thromboembolic disorder,arterial cerebrovascular thromboembolic disorder, venous cerebrovascularthromboembolic disorder or thromboembolic disorder in the heart chamberor in the peripheral circulation.
 24. The method according to claim 22,wherein the thromboembolic disease is coronary artery disease, unstableangina, acute coronary syndrome, atrial fibrillation, myocardialinfarction, ischemic sudden death, transient ischemic attack, cerebralstroke, peripheral arterial disease, atherosclerosis, peripheralocclusive arterial disease, venous thrombosis, venous thromboembolism,deep venous thrombosis, thrombophlebitis, arterial embolism, coronaryartery thrombosis, cerebral arterial thrombosis, cerebral embolism,kidney embolism, portal vein thrombosis, pulmonary embolism, pulmonaryinfarction, liver embolism, hepatic veno-occlusive disease/sinusoidalobstruction syndrome, thrombotic microangiopathy, disseminatedintravascular coagulation, sepsis, acute respiratory distress syndrome,acute lung injury, antiphospholipid antibody syndrome, thrombosisresulting from coronary artery bypass graft surgery or thrombosisinduced by treatment in which blood is exposed to an artificial surfacewhich promotes thrombus formation.
 25. The method according to claim 22,wherein the thromboembolic disease is venous thromboembolism, ischemicstroke, thromboembolic disease induced by treatment in which blood isexposed to an artificial surface which promotes thrombus formation,acute coronary syndrome, coronary artery disease or peripheral arterialdisease.
 26. The compound according to claim 15, wherein the compoundrepresented by general formula (I) is selected from the group consistingof the following compounds; (1)(3S)-3-[5-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H-imidazol-2-yl]-7-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-2,3-dihydro-5(1H)-indolizinone,(2)(6S)-6-[2-(6-amino-2-fluoro-3-pyridinyl)-4-fluoro-1H-imidazol-5-yl]-2-[5-chloro-2-(1H-tetrazol-1-yl)phenyl]-7,8-dihydropyrrolo[1,2-a]pyrimidin-4(6H)-one,and (3)1-(2-{(3S)-3-[5-(4-aminophenyl)-4-fluoro-1H-imidazol-2-yl]-5-oxo-1,2,3,5-tetrahydro-7-indolizinyl}-4-chlorophenyl)-1H-1,2,3-triazole-4-carbonitrile,a salt thereof, a solvate thereof, an N-oxide thereof or a prodrugthereof.